Healthcare Provider Details

I. General information

NPI: 1386367514
Provider Name (Legal Business Name): HEALING JOURNEYS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 MCLEOD RD NE STE E
ALBUQUERQUE NM
87109-2467
US

IV. Provider business mailing address

7112 WREN WALK DR NE
ALBUQUERQUE NM
87109-6108
US

V. Phone/Fax

Practice location:
  • Phone: 505-362-4536
  • Fax:
Mailing address:
  • Phone: 505-362-4536
  • 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 Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL L PAHOS
Title or Position: OWNER
Credential: LCSW
Phone: 505-362-4536