Healthcare Provider Details

I. General information

NPI: 1780577585
Provider Name (Legal Business Name): EPIPHANY MENTAL HEALTH COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 CYNTHIA CT NW
ALBUQUERQUE NM
87114-2413
US

IV. Provider business mailing address

209 CYNTHIA CT NW
ALBUQUERQUE NM
87114-2413
US

V. Phone/Fax

Practice location:
  • Phone: 505-252-2230
  • Fax:
Mailing address:
  • Phone: 505-252-2230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: NAOMI L DRIGGERS
Title or Position: MENTAL HEALTH THERAPIST
Credential: LPCC
Phone: 505-252-2230