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Organization
SOVEREIGN SELF, LLC
Active
Organization
SOVEREIGN SELF, LLC
Active
Other names
Sovereign Self Mental Health, Sovereign Self Mental Health and Self Care Lounge
Organization subpart
No
Provider details
NPI number
Authorized official
NINA WILSON LPC, LPCC (OWNER)
(308) 778-7020
Entity
Organization
Contact information
Practice address
3620 WYOMING BLVD NE STE 218, ALBUQUERQUE, NM 87111-3289
(720) 446-6563
Mailing address
3620 WYOMING BLVD NE STE 218, ALBUQUERQUE, NM 87111-3289
(308) 778-7020
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/14/2025
Last updated
09/16/2025
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