Healthcare Provider Details

I. General information

NPI: 1326955303
Provider Name (Legal Business Name): NEIGHBORHOOD THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 WILLOW BACK RD
SANTA FE NM
87508-1484
US

IV. Provider business mailing address

39 WILLOW BACK RD
SANTA FE NM
87508-1484
US

V. Phone/Fax

Practice location:
  • Phone: 973-572-7961
  • Fax:
Mailing address:
  • Phone: 973-572-7961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRANDON N PETERSON
Title or Position: OWNER
Credential: LPCC
Phone: 973-572-7961