Provider Demographics
NPI:1093104499
Name:JIMENEZ-MOTA, NANCY (MED, LPC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:JIMENEZ-MOTA
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 FLUSHING QUAIL DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3357
Mailing Address - Country:US
Mailing Address - Phone:817-713-1025
Mailing Address - Fax:
Practice Address - Street 1:1601 E LAMAR BLVD
Practice Address - Street 2:STE 210
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4510
Practice Address - Country:US
Practice Address - Phone:817-522-1095
Practice Address - Fax:817-460-0286
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71727101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional