Provider Demographics
NPI:1801425756
Name:ZIA VISTA THERAPY, LLC
Entity type:Organization
Organization Name:ZIA VISTA THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALDESPINO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:575-265-0582
Mailing Address - Street 1:277 E AMADOR AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-3676
Mailing Address - Country:US
Mailing Address - Phone:575-265-0582
Mailing Address - Fax:575-636-2500
Practice Address - Street 1:277 E AMADOR AVE STE 309
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-3676
Practice Address - Country:US
Practice Address - Phone:575-265-0582
Practice Address - Fax:575-636-2500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty