Healthcare Provider Details
I. General information
NPI: 1760398432
Provider Name (Legal Business Name): HEART SPEAK MENTAL HEALTH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
204 CARLISLE BLVD NE
ALBUQUERQUE NM
87106-1317
US
IV. Provider business mailing address
204 CARLISLE BLVD NE
ALBUQUERQUE NM
87106-1317
US
V. Phone/Fax
- Phone: 505-350-1101
- Fax:
- Phone: 505-350-1101
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LORI
LAVASEK
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 505-350-1101