Provider Demographics
NPI:1134642820
Name:NUEVA ESPERANZA LLC
Entity Type:Organization
Organization Name:NUEVA ESPERANZA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ ANAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MHR, LPC-S
Authorized Official - Phone:918-215-9626
Mailing Address - Street 1:1601 SW 89TH ST STE D200
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6383
Mailing Address - Country:US
Mailing Address - Phone:918-215-9626
Mailing Address - Fax:405-602-0918
Practice Address - Street 1:1601 SW 89TH ST STE D200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6383
Practice Address - Country:US
Practice Address - Phone:918-215-9626
Practice Address - Fax:405-602-0918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4322261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health