Healthcare Provider Details

I. General information

NPI: 1023965068
Provider Name (Legal Business Name): SANTA FE ART THERAPY & COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 EARLY ST UNIT C106A
SANTA FE NM
87505-1607
US

IV. Provider business mailing address

6962 GOLDEN MESA
SANTA FE NM
87507-3457
US

V. Phone/Fax

Practice location:
  • Phone: 505-718-4706
  • Fax:
Mailing address:
  • Phone:
  • 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: AMBER JOHNSON
Title or Position: OWNER/THERAPIST
Credential: MA LPCC
Phone: 505-718-4706