Healthcare Provider Details

I. General information

NPI: 1316893936
Provider Name (Legal Business Name): WILDFLOWER SERENITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 SAN PEDRO DR NE STE 115
ALBUQUERQUE NM
87110-4156
US

IV. Provider business mailing address

5608 WHEELWRIGHT AVE NW
ALBUQUERQUE NM
87120-3361
US

V. Phone/Fax

Practice location:
  • Phone: 505-804-1052
  • Fax:
Mailing address:
  • Phone: 505-804-1052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: AMY ALBERTUS
Title or Position: MANAGING MEMBER
Credential: LPCC
Phone: 505-804-1052