Healthcare Provider Details

I. General information

NPI: 1396985271
Provider Name (Legal Business Name): INFINITE POSSIBILITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2009
Last Update Date: 03/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1474 S SAINT FRANCIS DR
SANTA FE NM
87505-4038
US

IV. Provider business mailing address

1474 S SAINT FRANCIS DR
SANTA FE NM
87505-4038
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-5504
  • Fax: 505-988-5504
Mailing address:
  • Phone: 505-988-5504
  • Fax: 505-988-5504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2906
License Number StateNM

VIII. Authorized Official

Name: MR. THOMAS E WELTER
Title or Position: PRESIDENT/THERAPIST
Credential: LPCC
Phone: 505-988-5504