=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942169198
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ENERGIZED MINDS THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2026
-----------------------------------------------------
Last Update Date | 01/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1990 E LOHMAN AVE STE 117
-----------------------------------------------------
City | LAS CRUCES
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88001-3172
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-805-7748
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1990 E LOHMAN AVE STE 117
-----------------------------------------------------
City | LAS CRUCES
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88001-3172
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-805-7748
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OUTPATIENT THERAPIST
-----------------------------------------------------
Name | ANTHONY THOMAS ESQUIBEL
-----------------------------------------------------
Credential | LPCC
-----------------------------------------------------
Telephone | 575-805-7748
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------