Healthcare Provider Details

I. General information

NPI: 1477321990
Provider Name (Legal Business Name): FOCUS ON HEALING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 12/14/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

7191 W FIREBIRD DR
GLENDALE AZ
85308-9581
US

V. Phone/Fax

Practice location:
  • Phone: 480-665-0200
  • Fax:
Mailing address:
  • Phone: 480-665-0200
  • 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: KELI MAUREEN DERSCH-BALDONADO
Title or Position: OWNER/DIRECTOR
Credential: LPCC
Phone: 480-665-0200