Vaillancourt, Kourtney T.

Vaillancourt, Kourtney T. is an sole proprietor health care provider with primary practice located at 619 N Alameda Blvd , Las Cruces NM 88005-2130. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Vaillancourt, Kourtney T. can be contacted via phone (575) 405-7146.

Contact Information

Primary practice address
619 N Alameda Blvd Las Cruces NM 88005-2130
Phone: (575) 405-7146
Fax: (575) 405-5446
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0109031 New Mexico
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0102221 New Mexico
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0109041 New Mexico

Profile Details

NPI number 1003009432
LBN Legal business name Vaillancourt, Kourtney T.
Credentials PH.D, LMFT, LADAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 20th, 2007
Last updated Nov 16th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1003009432 NPPES
New Mexico MEDICAID 80302386

Popular Providers