Healthcare Provider Details
I. General information
NPI: 1174476097
Provider Name (Legal Business Name): ECOTHERAPY NM LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/19/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 LENA ST
SANTA FE NM
87505-3891
US
IV. Provider business mailing address
3 CUESTA LN
SANTA FE NM
87508-8331
US
V. Phone/Fax
- Phone: 213-537-8070
- Fax:
- Phone: 213-537-8070
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATTHEW
KLEPPER
Title or Position: OWNER
Credential: MA LPCC
Phone: 213-537-8070