Healthcare Provider Details

I. General information

NPI: 1275442857
Provider Name (Legal Business Name): DESERT WILLOW THERAPY AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 BARBARA LOOP SE STE 101
RIO RANCHO NM
87124-1040
US

IV. Provider business mailing address

1401 PENASCO RD NE
RIO RANCHO NM
87144-6320
US

V. Phone/Fax

Practice location:
  • Phone: 505-585-9704
  • Fax:
Mailing address:
  • Phone: 505-585-9704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAUREN ELIZABETH MORALES
Title or Position: OWNER/ CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 505-585-9704