Provider Demographics
NPI:1104035146
Name:DEL TORO, HECTOR ENRIQUEZ (MA, LPC-S)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:ENRIQUEZ
Last Name:DEL TORO
Suffix:
Gender:M
Credentials:MA, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11704 SWEETWATER TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1336
Mailing Address - Country:US
Mailing Address - Phone:512-913-6653
Mailing Address - Fax:512-774-6132
Practice Address - Street 1:11704 SWEETWATER TRL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1336
Practice Address - Country:US
Practice Address - Phone:512-913-6653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TX63079101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX220009902Medicaid