Healthcare Provider Details

I. General information

NPI: 1336066307
Provider Name (Legal Business Name): ALIGN AND THRIVE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 AMORAK RD
RANCHOS DE TAOS NM
87557-8720
US

IV. Provider business mailing address

17 AMORAK RD
RANCHOS DE TAOS NM
87557-8720
US

V. Phone/Fax

Practice location:
  • Phone: 575-224-1112
  • Fax:
Mailing address:
  • Phone: 575-224-1112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARY EMALIE TIPTON
Title or Position: OWNER/MANAGING MEMBER
Credential: LPCC
Phone: 575-224-1112