Individual
SHANNON B TRUJILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, LADAC
Contact information
Practice address
650 W MAIN ST, FARMINGTON, NM 87401-8445
(505) 787-2616
Mailing address
653 W ARRINGTON ST, FARMINGTON, NM 87401-8513
(505) 564-3733
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CCMH0197421
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAD0185291
NM
101YP2500X
Professional Counselor
CCMH0197421
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40803520
—
NM
Enumeration date
08/20/2009
Last updated
07/22/2025
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