Healthcare Provider Details

I. General information

NPI: 1689452328
Provider Name (Legal Business Name): SANA COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2023
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4809 HAYDEN PL NW
ALBUQUERQUE NM
87120-3227
US

IV. Provider business mailing address

4809 HAYDEN PL NW
ALBUQUERQUE NM
87120-3227
US

V. Phone/Fax

Practice location:
  • Phone: 505-350-1011
  • Fax:
Mailing address:
  • Phone: 505-350-1011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROZANNE M HURST
Title or Position: OWNER
Credential: LPCC
Phone: 505-350-1011