Healthcare Provider Details

I. General information

NPI: 1801461553
Provider Name (Legal Business Name): HEART IN HARMONY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 09/21/2021
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 WYOMING BLVD NE STE 203V
ALBUQUERQUE NM
87112-1033
US

IV. Provider business mailing address

3604 BRITT ST NE
ALBUQUERQUE NM
87111-4983
US

V. Phone/Fax

Practice location:
  • Phone: 505-307-0871
  • Fax:
Mailing address:
  • Phone: 505-307-0871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: AMY FLINKO
Title or Position: SW/DIRECTOR/OWNER
Credential: LCSW
Phone: 505-307-0871