Healthcare Provider Details

I. General information

NPI: 1346586989
Provider Name (Legal Business Name): WELLNESS FROM WITHIN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2013
Last Update Date: 12/01/2024
Certification Date: 12/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10052 COORS BLVD NW
ALBUQUERQUE NM
87114-4020
US

IV. Provider business mailing address

PO BOX 66255
ALBUQUERQUE NM
87193-6255
US

V. Phone/Fax

Practice location:
  • Phone: 505-459-0025
  • Fax: 505-899-8372
Mailing address:
  • Phone: 505-459-0025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. SANDRA Y. HERRERA-SPINELLI
Title or Position: EXECUTIVE DIRECTOR
Credential: LISW, DSW
Phone: 505-459-0025