Provider Demographics
NPI:1174406987
Name:CHANGING SEASONS THERAPY, LLC
Entity type:Organization
Organization Name:CHANGING SEASONS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DOMINICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-288-1105
Mailing Address - Street 1:119 QUAIL HILL TRL
Mailing Address - Street 2:
Mailing Address - City:PENA BLANCA
Mailing Address - State:NM
Mailing Address - Zip Code:87041-5106
Mailing Address - Country:US
Mailing Address - Phone:505-288-1105
Mailing Address - Fax:
Practice Address - Street 1:2601 WYOMING BLVD NE STE 212
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1033
Practice Address - Country:US
Practice Address - Phone:505-288-1105
Practice Address - Fax:888-830-6839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical