Healthcare Provider Details

I. General information

NPI: 1194473082
Provider Name (Legal Business Name): EMBODIMENT COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7820 ENCHANTED HILLS BLVD NE STE A177
RIO RANCHO NM
87144-8638
US

IV. Provider business mailing address

7820 ENCHANTED HILLS BLVD NE STE A177
RIO RANCHO NM
87144-8638
US

V. Phone/Fax

Practice location:
  • Phone: 505-929-9224
  • Fax:
Mailing address:
  • Phone: 505-372-4918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: IRMA JESSICA SALGADO
Title or Position: THERAPIST
Credential: LCSW
Phone: 505-372-4918