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General NPI Number Information
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NPI Number | 1902773443
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Entity Type | Organization
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Legal Business Name | RISK TO BLOOM THERAPY, LLC
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 4111 BARBARA LOOP SE STE E1
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City | RIO RANCHO
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State | NM
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Zip | 87124-1068
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Country | US
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Telephone | 505-738-5032
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 56571
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City | ALBUQUERQUE
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State | NM
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Zip | 87187-6571
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Country | US
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Telephone | 505-738-5032
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | ELIZABETH KRAUS
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Credential | LCSW
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Telephone | 505-738-5032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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