Provider Demographics
NPI:1962084525
Name:ESPINOZA PROFESSIONAL SERVICES, LLC
Entity type:Organization
Organization Name:ESPINOZA PROFESSIONAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOZA-MADRID
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:870-292-0049
Mailing Address - Street 1:114 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-4311
Mailing Address - Country:US
Mailing Address - Phone:870-345-3214
Mailing Address - Fax:870-361-6017
Practice Address - Street 1:114 S ELM ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-4311
Practice Address - Country:US
Practice Address - Phone:870-345-3214
Practice Address - Fax:870-361-6017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty