Healthcare Provider Details

I. General information

NPI: 1326953142
Provider Name (Legal Business Name): BORDERLANDS HEALING COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 E MESA AVE APT 17
LAS CRUCES NM
88001-5786
US

IV. Provider business mailing address

PO BOX 352
MESILLA PARK NM
88047-0352
US

V. Phone/Fax

Practice location:
  • Phone: 915-497-5503
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: GABRIELA LIZZETTE PRIETO
Title or Position: OWNER
Credential: LCSW
Phone: 915-497-5503