Organization
HIGH DESERT HEALING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP TATORIS LCSW (PSYCHOTHERAPIST)
(505) 717-1332
Entity
Organization
Contact information
Practice address
4201 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4808
(505) 717-1332
Mailing address
4201 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4808
(505) 717-1332
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54383315
—
NM
Enumeration date
03/07/2018
Last updated
12/13/2024
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