Healthcare Provider Details

I. General information

NPI: 1699515924
Provider Name (Legal Business Name): HEALING RESOURCES MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 CARLISLE BLVD NE
ALBUQUERQUE NM
87110-4965
US

IV. Provider business mailing address

436 8TH AVE N
ST PETERSBURG FL
33701-2330
US

V. Phone/Fax

Practice location:
  • Phone: 505-225-8962
  • Fax:
Mailing address:
  • Phone: 612-232-6902
  • 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: MINDY S GRUIDL
Title or Position: THERAPIST
Credential: LPCC
Phone: 612-232-6902