Neysla Cisneros, LAMFT
Individual provider Active NPI Marriage & Family Therapist · Hatch, NM
NPI 1649752718 · NPPES record last updated Sep 5, 2018
Key facts
- NPI
- 1649752718
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- CTL0198561 (NM)
- Practice address
- 255 Hwy 187
Hatch, NM 87937 - Phone
- (575) 267-3088
- Fax
- (575) 267-4565
- NPI assigned
- Sep 5, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240425001503 | NM | Practitioner - Marriage and Family Therapist | 7517307416 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CTL0198561 | NM | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vaillancourt Associates LLC Dba Alameda Marriage and Family Therapy | Marriage & Family Therapist | Current |
Accepting new patients |
Locations
619 N Alameda Blvd
Las Cruces, NM 88005
Phone (575) 201-3577
304 W Griggs Ave
Ste C
Las Cruces, NM 88005
Phone (575) 405-7146
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | CTL0198561 | NM | Yes |
Addresses
Primary practice location
255 Hwy 187
Hatch, NM 87937
Mailing address
PO Box 370
Hatch, NM 87937-0370
Phone (575) 267-3280
Other providers in Hatch, NM
- Ester Armijo
- Jennie Barela
- Ben Archer Health Center
- Ben Archer Health Center
- Laura Christine Boyd
- Tony Lee Clark
- Cristina Davis
- Patrick B Doherty
- Julia Escarsega
- America Garcia Cervantes
All providers in Hatch, NM · Marriage & Family Therapist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.