Provider Demographics
NPI:1275854523
Name:SANCHEZ, MAYRA AYDEE (LPC)
Entity Type:Individual
Prefix:
First Name:MAYRA
Middle Name:AYDEE
Last Name:SANCHEZ
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 1:1101 VINE AVE STE F
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4051
Mailing Address - Country:US
Mailing Address - Phone:564-511-6739
Mailing Address - Fax:956-290-8382
Practice Address - Street 1:1101 VINE AVE STE F
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4051
Practice Address - Country:US
Practice Address - Phone:956-451-1673
Practice Address - Fax:956-290-8382
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64302101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX833LQDOtherBLUE CROSS BLUE SHIELD OF TEXAS
TX2141335Medicaid