Sovereign Self, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SOVEREIGN SELF, LLC

Doing business as

Sovereign Self Mental Health
Sovereign Self Mental Health and Self Care Lounge

Practice address

3620 Wyoming Blvd NE Ste 218
Albuquerque, NM 87111-3289

Phone

(720) 446-6563

NPI assigned

Apr 14, 2025

Organization subpart

No

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

Authorized official

Name

Nina Wilson, LPC, LPCCNPI 1063878924

Title

Owner

Phone

(308) 778-7020

Specialties & licenses 1

Addresses

Other names 2

• Sovereign Self Mental Health Doing business as
• Sovereign Self Mental Health and Self Care Lounge Doing business as

Locations

Practitioners 1

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

• Nina Wilson, LPC

  • Professional Counselor
  • Albuquerque, NM
  • NPI 1063878924

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1366237901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 WYOMING BLVD NE STE 218",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113289",
            "telephone_number": "308-778-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 WYOMING BLVD NE STE 218",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113289",
            "telephone_number": "720-446-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN SELF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-778-7020",
        "authorized_official_credential": "LPC, LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sovereign Self Mental Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sovereign Self Mental Health and Self Care Lounge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Southwestern Women's Options, LLC
• Southwestern Women's Options, LLC
• Catherine B Sovereign, RDH, RD
• Christopher William Sovereign, LMT
• Kristina S Sowar, MD
• Desree A Sowers, MSN, FNP-BC
• Carrie J. Spackman

• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.