Healthcare Provider Details

I. General information

NPI: 1366128381
Provider Name (Legal Business Name): PEACE FOR JOY COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 GALISTEO RD APT B
SANTA FE NM
87505-5666
US

IV. Provider business mailing address

2710 GALISTEO ROAD APT B
SANTA FE NM
87505-5666
US

V. Phone/Fax

Practice location:
  • Phone: 505-570-3837
  • Fax:
Mailing address:
  • Phone: 575-770-1733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: GINA LORRAINE DELUCA
Title or Position: OWNER
Credential: LCSW
Phone: 575-770-1733