Healthcare Provider Details

I. General information

NPI: 1902721269
Provider Name (Legal Business Name): DOS CORAZONES COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 PRINCESS JEANNE DR
LAS CRUCES NM
88001-4155
US

IV. Provider business mailing address

1209 MOUNTAIN ROAD PL NE STE R
ALBUQUERQUE NM
87110-7825
US

V. Phone/Fax

Practice location:
  • Phone: 915-261-9098
  • 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: MARIA DE JESUS ROLDAN
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 915-261-9098