Healthcare Provider Details

I. General information

NPI: 1780515064
Provider Name (Legal Business Name): COLLECTIVE HEALING STUDIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N MIRANDA ST
LAS CRUCES NM
88005-2058
US

IV. Provider business mailing address

PO BOX 812
LAS CRUCES NM
88004-0812
US

V. Phone/Fax

Practice location:
  • Phone: 575-567-8576
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CARRIGEN CAIN
Title or Position: FOUNDER
Credential: LPCC
Phone: 575-567-8576