Healthcare Provider Details

I. General information

NPI: 1053249425
Provider Name (Legal Business Name): HEALING THE HEART THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7323 SIDEWINDER DR NE
ALBUQUERQUE NM
87113-1300
US

IV. Provider business mailing address

7323 SIDEWINDER DR NE
ALBUQUERQUE NM
87113-1300
US

V. Phone/Fax

Practice location:
  • Phone: 505-350-1375
  • Fax:
Mailing address:
  • Phone: 505-350-1375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE CHAVEZ MEDINA
Title or Position: MENTAL HEALTH THERAPIST
Credential: LPCC
Phone: 505-350-1375