| Sovereign Self, Llc | |
|
35 Cerro Del Alamo Santa Fe NM 87507-4250 | |
| (720) 446-6563 | |
| Not Available |
| Full Name | Sovereign Self, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 35 Cerro Del Alamo, Santa Fe, New Mexico |
| Authorized Official Name and Position | Nina Wilson (OWNER) |
| Authorized Official Contact | 3087787020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sovereign Self, Llc 17970 Road 58 Oshkosh NE 69154-5056 Ph: (308) 778-7020 | Sovereign Self, Llc 35 Cerro Del Alamo Santa Fe NM 87507-4250 Ph: (720) 446-6563 |
| NPI Number | 1366237901 |
|---|---|
| Provider Enumeration Date | 04/14/2025 |
| Last Update Date | 04/14/2025 |
| Certification Date | 04/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366237901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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