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General NPI Number Information
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NPI Number | 1720979016
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Entity Type | Organization
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Legal Business Name | EPIC COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 3510 MESSINA DR
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City | FARMINGTON
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State | NM
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Zip | 87402-4782
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Country | US
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Telephone | 505-320-5553
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 52
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City | FARMINGTON
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State | NM
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Zip | 87499-0052
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Country | US
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Telephone | 505-320-5553
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAWNA RILEY
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Credential | LPCC
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Telephone | 505-320-5553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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