Dorothy A. Coriz, LADAC

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

NPI 1609114149 · NPPES record last updated Jan 17, 2013

Key facts

NPI
1609114149
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
4055 (NM)
Practice address
1043 Highway 313
Bernalillo, NM 87004-6912
Phone
(505) 867-3351
Fax
(505) 867-3514
NPI assigned
Jan 17, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4055NMMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Five Sandoval Indian Pueblos, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dorothy.coriz.p1@direct.kp-hc.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 4055 NM Yes

Addresses

Primary practice location

1043 Highway 313
Bernalillo, NM 87004-6912

Mailing address

1043 Highway 313
Bernalillo, NM 87004-6912
Phone (505) 867-3351

Other providers in Bernalillo, NM

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

Sources for this page

Verify at the official NPI Registry.