Healthcare Provider Details

I. General information

NPI: 1891649141
Provider Name (Legal Business Name): DIVERGENT PERSPECTIVES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 CENTRAL AVE SW
ALBUQUERQUE NM
87102-2803
US

IV. Provider business mailing address

1509 2ND ST SW
ALBUQUERQUE NM
87102-4303
US

V. Phone/Fax

Practice location:
  • Phone: 505-585-1551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MARISSA KOUPF
Title or Position: OWNER
Credential: LCSW
Phone: 505-585-1550