MEDICARE: DIVERGENT PERSPECTIVES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1891649141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVERGENT PERSPECTIVES LLC

Provider Business Mailing Address
First Line	:	415 MULBERRY ST NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-4723
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 MULBERRY ST NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-4723
Country	:	US
Telephone Number	:	505-585-1551
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARISSA KOUPF
Credential	:	LCSW
Telephone Number	:	505-585-1550

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	03/02/2026

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Directions to “DIVERGENT PERSPECTIVES LLC ” Practice Location

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