Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Gavriella Grace Montoya Y Tierney, LSAA

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1871264267

Gavriella Grace Montoya Y Tierney, LSAA is an Undefined Non-Physician Type (Specify) in Albuquerque, New Mexico. Qualified in 2024, 2 years ago. Licensed in New Mexico.

Years since qualifying
2
Licensed in
NM
In the registry since
2021
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Practice location Address checks out

630 Haines Ave NW
Albuquerque, NM 87102-1226
Phone: (505) 268-5611
Fax: (505) 268-5736
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CSA0220211 (NM)

Record details

NPI number1871264267
Entity typeIndividual (Type 1)
GenderFemale
Credentials LSAA
Sole proprietorNo
NPI enumeratedSeptember 24, 2021
Last updated in NPPESSeptember 24, 2021
Certification dateSeptember 24, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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