Healthcare Provider Details

I. General information

NPI: 1063981660
Provider Name (Legal Business Name): HEALTHY MINDS COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2018
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7323 BOXWOOD AVE NE
ALBUQUERQUE NM
87113-2022
US

IV. Provider business mailing address

PO BOX 92332
ALBUQUERQUE NM
87199-2332
US

V. Phone/Fax

Practice location:
  • Phone: 505-350-3165
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JEANNIE MONTOYA
Title or Position: OWNER
Credential:
Phone: 505-350-3165