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General NPI Number Information
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NPI Number | 1962084525
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Entity Type | Organization
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Legal Business Name | ESPINOZA PROFESSIONAL SERVICES, LLC
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Dates
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Enumeration Date | 04/23/2021
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 114 S ELM ST
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City | HOPE
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State | AR
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Zip | 71801-4311
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Country | US
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Telephone | 870-345-3214
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Fax | 870-361-6017
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Provider Business Mailing Address
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Address Line | 114 S ELM ST
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City | HOPE
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State | AR
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Zip | 71801-4311
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Country | US
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Telephone | 870-345-3214
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Fax | 870-361-6017
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Authorized Official
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Title or Position | OWNER
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Name | CRISTIAM ESPINOZA-MADRID
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Credential | LPC
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Telephone | 870-292-0049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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