Provider Demographics
NPI:1073885398
Name:LOZANO, ROBERTO J (MS, LCDC, LPC)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:J
Last Name:LOZANO
Suffix:
Gender:M
Credentials:MS, LCDC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 CALLE DEL NORTE STE 400
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6041
Mailing Address - Country:US
Mailing Address - Phone:956-725-1308
Mailing Address - Fax:956-725-1380
Practice Address - Street 1:1303 CALLE DEL NORTE STE 400
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6041
Practice Address - Country:US
Practice Address - Phone:956-725-1308
Practice Address - Fax:956-725-1380
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10965101YA0400X
TX66626101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)