Healthcare Provider Details

I. General information

NPI: 1528801289
Provider Name (Legal Business Name): PURPOSE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 VASILION PL NW
ALBUQUERQUE NM
87120-6177
US

IV. Provider business mailing address

1719 VASILION PL NW
ALBUQUERQUE NM
87120-6177
US

V. Phone/Fax

Practice location:
  • Phone: 505-920-6387
  • Fax:
Mailing address:
  • Phone: 505-920-6387
  • 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: LETICIA MOLINA LANDEROS
Title or Position: LCSW, OUTPATIENT CLINICAL THERAPIST
Credential:
Phone: 505-920-6387