Provider Demographics
NPI:1114270881
Name:CONSCIOUS WELLNESS, LLC
Entity Type:Organization
Organization Name:CONSCIOUS WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:HEALEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:505-577-1409
Mailing Address - Street 1:1925 ASPEN DR
Mailing Address - Street 2:SUITE 402A
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-5459
Mailing Address - Country:US
Mailing Address - Phone:505-577-1409
Mailing Address - Fax:
Practice Address - Street 1:1925 ASPEN DR
Practice Address - Street 2:SUITE 402A
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5459
Practice Address - Country:US
Practice Address - Phone:505-577-1409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0094631251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health