Provider Demographics
NPI:1578243564
Name:GROUNDWORK THERAPY LLC
Entity Type:Organization
Organization Name:GROUNDWORK THERAPY LLC
Other - Org Name:AMY REICH THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-690-9590
Mailing Address - Street 1:PO BOX 24426
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87502-9426
Mailing Address - Country:US
Mailing Address - Phone:505-570-4509
Mailing Address - Fax:
Practice Address - Street 1:1418 LUISA ST STE 5A
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4091
Practice Address - Country:US
Practice Address - Phone:505-570-4509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty