Provider Demographics
NPI:1114267416
Name:ESQUEDA RIVERA, ERICA (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:ESQUEDA RIVERA
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9861 DYER STREE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79924-4747
Mailing Address - Country:US
Mailing Address - Phone:915-202-5778
Mailing Address - Fax:915-757-2526
Practice Address - Street 1:9861 DYER ST STE 2
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-4747
Practice Address - Country:US
Practice Address - Phone:915-202-5778
Practice Address - Fax:915-271-8112
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12025101YA0400X
TX68797101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)