Healthcare Provider Details

I. General information

NPI: 1497610893
Provider Name (Legal Business Name): ONE HEART ONE MIND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 HENDRIX RD NE
ALBUQUERQUE NM
87110-1091
US

IV. Provider business mailing address

6801 VERANO CT NW
ALBUQUERQUE NM
87120-6031
US

V. Phone/Fax

Practice location:
  • Phone: 505-553-2888
  • Fax:
Mailing address:
  • Phone: 505-553-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: VESTA PADILLA
Title or Position: OWNER
Credential: LPCC, LADAC
Phone: 505-553-2888