Divine Mental Healthcare Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

DIVINE MENTAL HEALTHCARE SERVICES LLC

Practice address

1900 N Mesa St Ste C
El Paso, TX 79902-3309

Phone

(915) 820-0315

NPI assigned

Oct 3, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lauretta Stubbs, NPNPI 1477859072

Title

Owner

Phone

(915) 820-0315

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lauretta Ndidiamaka Stubbs, FAMILY NURSE PRACTIT

  • Psychiatric/Mental Health Nurse Practitioner
  • El Paso, TX
  • NPI 1477859072
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698364800000",
    "number": "1205616679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 PETAYA LN",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799128497",
            "telephone_number": "915-820-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N MESA ST STE C",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799023309",
            "telephone_number": "915-820-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE MENTAL HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A",
        "authorized_official_last_name": "STUBBS",
        "authorized_official_first_name": "LAURETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-820-0315",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.