Provider Demographics
NPI:1346956620
Name:CHAVEZ, MAYRA LIZETH (MS,LPC)
Entity Type:Individual
Prefix:
First Name:MAYRA
Middle Name:LIZETH
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:MS,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13492 EMERALD TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-6495
Mailing Address - Country:US
Mailing Address - Phone:210-929-7010
Mailing Address - Fax:
Practice Address - Street 1:13492 EMERALD TERRACE DR
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-6495
Practice Address - Country:US
Practice Address - Phone:210-929-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82097101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health