Healthcare Provider Details

I. General information

NPI: 1801727466
Provider Name (Legal Business Name): INTENT THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 CARLISLE BLVD NE STE A
ALBUQUERQUE NM
87110-4971
US

IV. Provider business mailing address

2014 METZGAR RD SW
ALBUQUERQUE NM
87105-6427
US

V. Phone/Fax

Practice location:
  • Phone: 505-340-9569
  • Fax:
Mailing address:
  • Phone: 505-340-9569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LUISANA BALDONADO
Title or Position: OWNER
Credential: LCSW
Phone: 505-340-9569