Kindred Spirit Latino Center for Grief and Loss, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KINDRED SPIRIT LATINO CENTER FOR GRIEF AND LOSS, LLC

Practice address

908 E Ferguson St
Pharr, TX 78577-2614

Phone

(956) 342-4354

Fax

(956) 601-1272

NPI assigned

Jun 22, 2022

Organization subpart

No

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

Authorized official

Name

Enedina Elisa Enriquez, DSW, LCSW-SNPI 1891704052

Title

Owner

Phone

(956) 342-4354

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kindred Spirit Social & Community Services Former legal business name

Locations

Practitioners 1

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

• Enedina Elisa Enriquez, LCSW

  • Clinical Social Worker
  • Pharr, TX
  • NPI 1891704052
  NPD Authorized official

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1437880283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 E FERGUSON ST",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785772614",
            "telephone_number": "956-342-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 E FERGUSON ST",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785772614",
            "telephone_number": "956-342-4354",
            "fax_number": "956-601-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDRED SPIRIT LATINO CENTER FOR GRIEF AND LOSS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "ENRIQUEZ",
        "authorized_official_first_name": "ENEDINA",
        "authorized_official_middle_name": "ELISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-342-4354",
        "authorized_official_credential": "DSW, LCSW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891704052",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindred Spirit Social & Community Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Social Worker in Pharr, TX
• Providers in Pharr, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.