Provider Demographics
NPI:1316613128
Name:FORTIFIED MIND COUNSELING SERVICES, LLP
Entity type:Organization
Organization Name:FORTIFIED MIND COUNSELING SERVICES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-494-5931
Mailing Address - Street 1:9616 SUNDORO PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2987
Mailing Address - Country:US
Mailing Address - Phone:505-659-3067
Mailing Address - Fax:
Practice Address - Street 1:3005 LOUISIANA BLVD NE STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-2734
Practice Address - Country:US
Practice Address - Phone:505-494-5931
Practice Address - Fax:505-508-2163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty