Provider Demographics
NPI:1073824116
Name:VALLEY BEHAVIORAL CENTER FOR COUNSELING, PLLC
Entity Type:Organization
Organization Name:VALLEY BEHAVIORAL CENTER FOR COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MA
Authorized Official - Phone:956-517-9232
Mailing Address - Street 1:318 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4706
Mailing Address - Country:US
Mailing Address - Phone:956-517-9232
Mailing Address - Fax:956-627-4297
Practice Address - Street 1:318 N 15TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4706
Practice Address - Country:US
Practice Address - Phone:956-517-9232
Practice Address - Fax:956-627-4297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63732101YP2500X
TX165351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty