Provider Demographics
NPI:1225024110
Name:ALDERETTE, EDWARD (LMSW)
Entity Type:Individual
Prefix:PROF
First Name:EDWARD
Middle Name:
Last Name:ALDERETTE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:MR
Other - First Name:EDWARD
Other - Middle Name:
Other - Last Name:ALDERETTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:8245 FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3356
Mailing Address - Country:US
Mailing Address - Phone:210-616-0022
Mailing Address - Fax:210-616-0258
Practice Address - Street 1:8245 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3356
Practice Address - Country:US
Practice Address - Phone:210-616-0022
Practice Address - Fax:210-616-0258
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9601101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX9601OtherACP
TX9601OtherACP