MEDICARE: INTENT THERAPY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1801727466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTENT THERAPY SERVICES

Provider Business Mailing Address
First Line	:	2014 METZGAR RD SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87105-6427
Country	:	US
Telephone Number	:	505-340-9569
Fax Number	:

Provider Business Practice Location Address
First Line	:	1921 CARLISLE BLVD NE STE A
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-4971
Country	:	US
Telephone Number	:	505-340-9569
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LUISANA BALDONADO
Credential	:	LCSW
Telephone Number	:	505-340-9569

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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Directions to “INTENT THERAPY SERVICES ” Practice Location

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