NPIMap

Organization Active NPI

Enchanted Healing of New Mexico LLC

  • Clinical Social Worker
  • Tijeras, NM
National Provider Identifier
1497073217
Registry record updated May 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-06142 Issued in NM
Legal business name
ENCHANTED HEALING OF NEW MEXICO LLC
Practice address
21 Kuhn Dr
Tijeras, NM 87059-8101
Phone
(505) 362-5847
NPI assigned
May 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2010

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

Authorized official

Name
Delasaria Lihon, LISW
Title
Owner
Phone
(505) 362-5847

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X I-06142 NM
Pastoral CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP1600X I-06142 NM
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X I-06142 NM Primary

Addresses

Primary practice location

21 Kuhn Dr
Tijeras, NM 87059-8101

Mailing address

PO Box 23
Jemez Springs, NM 87025-0023
Phone (505) 362-5847

National Provider Directory

National Provider Directory
Tax ID family
Enchanted Healing of New Mexico LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273017600000",
    "number": "1497073217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23",
            "city": "JEMEZ SPRINGS",
            "state": "NM",
            "postal_code": "870250023",
            "telephone_number": "505-362-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 KUHN DR",
            "city": "TIJERAS",
            "state": "NM",
            "postal_code": "870598101",
            "telephone_number": "505-362-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCHANTED HEALING OF NEW MEXICO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-05",
        "last_updated": "2010-05-05",
        "status": "A",
        "authorized_official_last_name": "LIHON",
        "authorized_official_first_name": "DELASARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-362-5847",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "I-06142",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": "NM",
            "license": "I-06142",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-06142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tijeras, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.