Provider Demographics
NPI:1164196036
Name:LAIRD BARCENAS, AMBER N (PHD LPC NCC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:N
Last Name:LAIRD BARCENAS
Suffix:
Gender:F
Credentials:PHD LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 POINT VISTA RD APT 11103
Mailing Address - Street 2:
Mailing Address - City:HICKORY CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:75065-7659
Mailing Address - Country:US
Mailing Address - Phone:830-708-0534
Mailing Address - Fax:
Practice Address - Street 1:4431 LONG PRAIRIE RD STE 200
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1753
Practice Address - Country:US
Practice Address - Phone:972-432-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76711101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor