Healthcare Provider Details

I. General information

NPI: 1578420055
Provider Name (Legal Business Name): TREE OF LIFE NM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 BISBEE CT 109-67
SANTA FE NM
87508
US

IV. Provider business mailing address

109 BISBEE CT 109-67
SANTA FE NM
87508
US

V. Phone/Fax

Practice location:
  • Phone: 830-456-7346
  • Fax: 505-796-5112
Mailing address:
  • Phone: 830-456-7346
  • Fax: 505-796-5112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE CAMFIELD
Title or Position: OWNER
Credential: LCSW
Phone: 830-456-7346