Healthcare Provider Details

I. General information

NPI: 1316871924
Provider Name (Legal Business Name): HEALINGSOLS WELLNESS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 MORNING STAR DR UNIT 3305
LAS CRUCES NM
88011-1779
US

IV. Provider business mailing address

3650 MORNING STAR DR UNIT 3305
LAS CRUCES NM
88011-1779
US

V. Phone/Fax

Practice location:
  • Phone: 757-478-0901
  • Fax:
Mailing address:
  • Phone: 757-478-0901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SAYYID STANFORD
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 757-478-0901