Provider Demographics
NPI:1346251162
Name:BADILLO, DORI (LPC)
Entity Type:Individual
Prefix:
First Name:DORI
Middle Name:
Last Name:BADILLO
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 1:2150 W 18TH ST
Mailing Address - Street 2:SUITE 300- A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-5200
Mailing Address - Country:US
Mailing Address - Phone:281-831-8644
Mailing Address - Fax:713-526-9882
Practice Address - Street 1:2150 W 18TH ST
Practice Address - Street 2:SUITE 300- A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-5200
Practice Address - Country:US
Practice Address - Phone:281-831-8644
Practice Address - Fax:713-526-9882
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX027193403Medicaid