=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568377786
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOUBLE RAINBOW & LIGHTNING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2026
-----------------------------------------------------
Last Update Date | 08/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1600 LENA ST STE C26
-----------------------------------------------------
City | SANTA FE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87505-4340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-585-4287
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2012 VALLE RIO ST
-----------------------------------------------------
City | SANTA FE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87505-6127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-828-8563
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ELIZAB MORRILL
-----------------------------------------------------
Credential | LPCC
-----------------------------------------------------
Telephone | 603-828-8563
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------