Provider Demographics
NPI:1023193232
Name:MORALES, JOE R (LPC)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:R
Last Name:MORALES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WILDLIFE LN
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-1615
Mailing Address - Country:US
Mailing Address - Phone:936-238-3868
Mailing Address - Fax:936-238-3867
Practice Address - Street 1:103 WILDLIFE LN
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-1615
Practice Address - Country:US
Practice Address - Phone:936-238-3868
Practice Address - Fax:936-238-3867
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15494101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
26485OtherMAGELLAN
TX4019LCOtherBLUE CROSS BLUE SHIELD TX
TX0959405-01Medicaid