Angela V. Cordova, LSAA

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

NPI 1992681852 · NPPES record last updated Aug 14, 2025

Key facts

NPI
1992681852
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CTB-2025-0248 (NM)
Practice address
3204 Sheridan St
Clovis, NM 88101-5131
Phone
(575) 219-7262
NPI assigned
Aug 14, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CTB-2025-0248NMMDCounselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CTB-2025-0248 NM
Addiction (Substance Use Disorder) Counselor 101YA0400X CTB-2025-0248 NM Yes

Addresses

Primary practice location

3204 Sheridan St
Clovis, NM 88101-5131

Mailing address

3204 Sheridan St
Clovis, NM 88101-5131
Phone (575) 219-7262

Other providers in Clovis, NM

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

Sources for this page

Verify at the official NPI Registry.