Healthcare Provider Details

I. General information

NPI: 1275216384
Provider Name (Legal Business Name): LOZEN & COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 RIM VIEW RD
RANCHOS DE TAOS NM
87557
US

IV. Provider business mailing address

PO BOX 1748
RANCHOS DE TAOS NM
87557-1748
US

V. Phone/Fax

Practice location:
  • Phone: 505-633-0733
  • Fax: 505-472-8122
Mailing address:
  • Phone: 505-633-0733
  • Fax: 505-472-8122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AMANDA GALLEGOS
Title or Position: OWNER/CLINICIAN
Credential:
Phone: 505-633-0733