Healthcare Provider Details

I. General information

NPI: 1942169198
Provider Name (Legal Business Name): ENERGIZED MINDS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2026
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1990 E LOHMAN AVE STE 117
LAS CRUCES NM
88001-3172
US

IV. Provider business mailing address

1990 E LOHMAN AVE STE 117
LAS CRUCES NM
88001-3172
US

V. Phone/Fax

Practice location:
  • Phone: 575-805-7748
  • Fax:
Mailing address:
  • Phone: 575-805-7748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY THOMAS ESQUIBEL
Title or Position: OUTPATIENT THERAPIST
Credential: LPCC
Phone: 575-805-7748