Provider Demographics
NPI:1275828766
Name:CERVANTES, JULIO (LPC)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:CERVANTES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 N JOSEY LN
Mailing Address - Street 2:STE. 250
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5543
Mailing Address - Country:US
Mailing Address - Phone:972-466-2800
Mailing Address - Fax:
Practice Address - Street 1:2625 N JOSEY LN
Practice Address - Street 2:STE. 250
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5543
Practice Address - Country:US
Practice Address - Phone:972-466-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65726101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health