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General NPI Number Information
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NPI Number | 1467309690
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Entity Type | Organization
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Legal Business Name | ENCHANTEDJOURNEYTHERAPEUTICS, LLC
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 5512 KALAHARI LN
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City | LAS CRUCES
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State | NM
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Zip | 88011
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Country | US
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Telephone | 575-952-0652
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Fax |
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Provider Business Mailing Address
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Address Line | 2260 E LOHMAN AVE # 1166
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City | LAS CRUCES
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State | NM
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Zip | 88001-8490
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Country | US
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Telephone | 575-952-0652
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER/OWNER
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Name | DR. GABRIELLA MICELI
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Credential | PH.D.
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Telephone | 575-952-0652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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