Healthcare Provider Details

I. General information

NPI: 1851238588
Provider Name (Legal Business Name): SANTA FE WELLNESS AND THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 2ND ST STE 28
SANTA FE NM
87505-3801
US

IV. Provider business mailing address

1807 2ND ST STE 28
SANTA FE NM
87505-3801
US

V. Phone/Fax

Practice location:
  • Phone: 505-690-0040
  • Fax:
Mailing address:
  • Phone: 505-690-0040
  • 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: MS. ELIZABETH A CAROVILLANO
Title or Position: OWNER
Credential: LPCC
Phone: 505-690-0040