Organization Active NPI

Changing Seasons Therapy, LLC

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1174406987
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CHANGING SEASONS THERAPY, LLC
Practice address
2601 Wyoming Blvd NE Ste 212
Albuquerque, NM 87112-1033
Phone
(505) 288-1105
Fax
(888) 830-6839
NPI assigned
Jul 29, 2025
Last updated
Jul 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dominica Montano, LCSWNPI 1164060976
Title
Mental Health Therapist
Phone
(505) 288-1105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

2601 Wyoming Blvd NE Ste 212
Albuquerque, NM 87112-1033

Mailing address

119 Quail Hill TRL
Pena Blanca, NM 87041-5106
Phone (505) 288-1105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251008000086 NM Part B Supplier - Clinic/Group Practice 8325545239 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1174406987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 QUAIL HILL TRL",
            "city": "PENA BLANCA",
            "state": "NM",
            "postal_code": "870415106",
            "telephone_number": "505-288-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 WYOMING BLVD NE STE 212",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871121033",
            "telephone_number": "505-288-1105",
            "fax_number": "888-830-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING SEASONS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "MONTANO",
        "authorized_official_first_name": "DOMINICA",
        "authorized_official_title_or_position": "MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "505-288-1105",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.