# CYFD-STATE OF NEW MEXICO-FFT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Functional Family Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124194600
- **Authorized official:** MR. MINOR MORGAN LISW (BUREAU CHIEF, CYFDJJS ENTITLEMENT)
- **Authorized official phone:** (505) 841-6372

## Contact information

- **Practice address:** 300 SAN MATEO BLVD NE STE 410, 300 SAN MATEO BLVD NE STE 410, ALBUQUERQUE, NM 87108-1503
- **Practice address phone:** (505) 841-6372
- **Practice address fax:** (505) 841-2949
- **Mailing address:** 300 SAN MATEO BLVD NE STE 410, 300 SAN MATEO BLVD NE STE 410, ALBUQUERQUE, NM 87108-1503
- **Mailing address phone:** (505) 841-6372
- **Mailing address fax:** (505) 841-2949

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 11/28/2006
- **Last updated:** 08/07/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | NM600533VNM00237OT | VALUE OPTIONS | NM |