Healthcare Provider Details

I. General information

NPI: 1578357117
Provider Name (Legal Business Name): BIRD AND COMPASS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 MANZANARES AVE E
SOCORRO NM
87801-4213
US

IV. Provider business mailing address

114 MANZANARES AVE E
SOCORRO NM
87801-4213
US

V. Phone/Fax

Practice location:
  • Phone: 575-747-1460
  • Fax:
Mailing address:
  • Phone: 575-747-1460
  • Fax: 406-272-7191

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: AMY ALLISON RAY
Title or Position: OWNER
Credential: MHC
Phone: 575-747-1460