Provider Demographics
NPI:1174640510
Name:GUAJARDO, NORAIDA (LPC)
Entity Type:Individual
Prefix:
First Name:NORAIDA
Middle Name:
Last Name:GUAJARDO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 DEL ORO LN
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-2200
Mailing Address - Country:US
Mailing Address - Phone:956-330-1555
Mailing Address - Fax:956-787-7675
Practice Address - Street 1:804 DEL ORO LN
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-2200
Practice Address - Country:US
Practice Address - Phone:956-330-1555
Practice Address - Fax:956-787-7675
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14988101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX028511601Medicaid
TX203986869OtherTAX ID
TX84424LOtherBLUE CROSS BLUE SHIELD #