Healthcare Provider Details

I. General information

NPI: 1891313185
Provider Name (Legal Business Name): ELIZA DELANEY LPCC, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 BRUNN SCHOOL RD STE C
SANTA FE NM
87505-1102
US

IV. Provider business mailing address

542 ALTO ST
SANTA FE NM
87501-2564
US

V. Phone/Fax

Practice location:
  • Phone: 505-234-6024
  • Fax:
Mailing address:
  • Phone: 405-818-5524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11903599-6004
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number20-402
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2023-0750
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: