Provider Demographics
NPI:1154197390
Name:AFFIRM THERAPY CONNECTIONS PLLC
Entity type:Organization
Organization Name:AFFIRM THERAPY CONNECTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:PERMENTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-437-2714
Mailing Address - Street 1:5000 S WESTERN ST # 19703
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-6192
Mailing Address - Country:US
Mailing Address - Phone:303-437-2714
Mailing Address - Fax:
Practice Address - Street 1:2406 JUNIPER DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1916
Practice Address - Country:US
Practice Address - Phone:303-437-2714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty