Triston Shane Eriacho, LSAA

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Pine Hill, NM

NPI 1023934379 · NPPES record last updated Jun 29, 2026

Key facts

NPI
1023934379
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CTB-2023-0738 (NM)
Practice address
Bia RT. 125 Behavioral Health Road
Pine Hill, NM 87357
Phone
(505) 775-3353
Fax
(505) 775-3630
NPI assigned
Jun 29, 2026
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CTB-2023-0738 NM Yes

Addresses

Primary practice location

Bia RT. 125 Behavioral Health Road
Pine Hill, NM 87357

Mailing address

PO Box 490
Pinehill, NM 87357-0490
Phone (505) 775-3353

Other providers in Pine Hill, NM

All providers in Pine Hill, NM · Addiction (Substance Use Disorder) Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.