Healthcare Provider Details

I. General information

NPI: 1568377786
Provider Name (Legal Business Name): DOUBLE RAINBOW & LIGHTNING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 LENA ST STE C26
SANTA FE NM
87505-4340
US

IV. Provider business mailing address

2012 VALLE RIO ST
SANTA FE NM
87505-6127
US

V. Phone/Fax

Practice location:
  • Phone: 505-585-4287
  • Fax:
Mailing address:
  • Phone: 603-828-8563
  • 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: ELIZAB MORRILL
Title or Position: OWNER
Credential: LPCC
Phone: 603-828-8563