Provider Demographics
NPI:1326513292
Name:PENA, VICTORIA ANNETTE (LPC)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:ANNETTE
Last Name:PENA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:902 S PALM COURT DR APT 9201
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-4425
Mailing Address - Country:US
Mailing Address - Phone:956-659-0949
Mailing Address - Fax:
Practice Address - Street 1:722 MORGAN BLVD STE D
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-5124
Practice Address - Country:US
Practice Address - Phone:956-659-0949
Practice Address - Fax:210-247-9611
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79183101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional