Provider Demographics
NPI:1184232027
Name:ACOSTA, JOCELYN GUADALUPE (LAC, LPCC, MFTC)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:GUADALUPE
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:LAC, LPCC, MFTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 PRAIRIE RYE DR
Mailing Address - Street 2:
Mailing Address - City:LAGO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78645-2134
Mailing Address - Country:US
Mailing Address - Phone:281-896-7900
Mailing Address - Fax:
Practice Address - Street 1:8201 PRAIRIE RYE DR
Practice Address - Street 2:
Practice Address - City:LAGO VISTA
Practice Address - State:TX
Practice Address - Zip Code:78645-2134
Practice Address - Country:US
Practice Address - Phone:281-896-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001561101YA0400X
COMFTC.0013929106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist