Provider Demographics
NPI:1194000273
Name:NARES, GEORGINA MUJICA (LPC)
Entity Type:Individual
Prefix:
First Name:GEORGINA
Middle Name:MUJICA
Last Name:NARES
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 1:6601 CAROLINA PNE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3020
Mailing Address - Country:US
Mailing Address - Phone:956-466-3640
Mailing Address - Fax:
Practice Address - Street 1:2035 PRICE RD, STE D
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521
Practice Address - Country:US
Practice Address - Phone:956-542-2536
Practice Address - Fax:956-504-2537
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64133101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor