Healthcare Provider Details

I. General information

NPI: 1154283315
Provider Name (Legal Business Name): BECOMING WELL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 TIERRA MADRE RD
PLACITAS NM
87043-9400
US

IV. Provider business mailing address

43 TIERRA MADRE RD
PLACITAS NM
87043-9400
US

V. Phone/Fax

Practice location:
  • Phone: 505-585-1852
  • Fax:
Mailing address:
  • Phone: 505-585-1852
  • 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: MR. MATTHEW ROY BURTON
Title or Position: MANAGING DIRECTOR
Credential: PHD, M.S.
Phone: 425-563-0537