Healthcare Provider Details

I. General information

NPI: 1902773443
Provider Name (Legal Business Name): RISK TO BLOOM THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 BARBARA LOOP SE STE E1
RIO RANCHO NM
87124-1068
US

IV. Provider business mailing address

PO BOX 56571
ALBUQUERQUE NM
87187-6571
US

V. Phone/Fax

Practice location:
  • Phone: 505-738-5032
  • Fax:
Mailing address:
  • Phone: 505-738-5032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH KRAUS
Title or Position: PSYCHOTHERAPIST
Credential: LCSW
Phone: 505-738-5032