Healthcare Provider Details

I. General information

NPI: 1992664015
Provider Name (Legal Business Name): HEALING MONTANAS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 S MAIN ST STE 2
LAS CRUCES NM
88001-1266
US

IV. Provider business mailing address

2360 E LOHMAN AVE # 1139
LAS CRUCES NM
88001-8492
US

V. Phone/Fax

Practice location:
  • Phone: 575-323-0033
  • Fax:
Mailing address:
  • Phone: 575-323-0033
  • 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: MRS. KRYSTYNA GONZALEZ
Title or Position: PSYCHOTHERAPIST
Credential: MSW, LCSW
Phone: 575-323-0033