Basic Information
| Provider Information | |||||||||
| NPI: | 1649865650 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SENDEROS COUNSELING SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6090 SURETY DR STE 420 | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799052057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9153039216 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4613 LOMA ESCONDIDA DR | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799343538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152031387 | ||||||||
| FaxNumber: | 9153039216 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2021 | ||||||||
| LastUpdateDate: | 03/02/2021 | ||||||||
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| AuthorizedOfficialLastName: | URBINA | ||||||||
| AuthorizedOfficialFirstName: | LUISA | ||||||||
| AuthorizedOfficialMiddleName: | ELBERG | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT CEO | ||||||||
| AuthorizedOfficialTelephone: | 9153039215 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| NPICertificationDate: | 03/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.