Healthcare Provider Details

I. General information

NPI: 1639593486
Provider Name (Legal Business Name): EMPOWERMENT COUNSELING SERVICE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2014
Last Update Date: 02/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 MARQUETTE STREET
ALBUQUERQUE NM
87102
US

IV. Provider business mailing address

59 ACADIA CT SE
RIO RANCHO NM
87124-3662
US

V. Phone/Fax

Practice location:
  • Phone: 505-410-0050
  • Fax:
Mailing address:
  • Phone: 505-410-0050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0137531
License Number StateNM

VIII. Authorized Official

Name: LINDA ANN HAMMOND
Title or Position: LICENSED CLINICAL PROFESSIONAL COUN
Credential: LPCC
Phone: 505-410-0050