Healthcare Provider Details

I. General information

NPI: 1538275532
Provider Name (Legal Business Name): HOPE SPRINGS WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1918 HOPEWELL ST APT A
SANTA FE NM
87505-3857
US

IV. Provider business mailing address

PO BOX 6338
SANTA FE NM
87502-6338
US

V. Phone/Fax

Practice location:
  • Phone: 505-690-0995
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI05491
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0077101
License Number StateNM

VIII. Authorized Official

Name: MELODY BOLEN
Title or Position: PARTNER
Credential: L.M.F.T
Phone: 505-992-8900