Healthcare Provider Details

I. General information

NPI: 1558244269
Provider Name (Legal Business Name): EXPRESSIVE HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
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

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

V. Phone/Fax

Practice location:
  • Phone: 505-234-6024
  • Fax:
Mailing address:
  • Phone:
  • 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: ELIZA DELANEY
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LPCC, ATR-BC
Phone: 505-234-6024