Provider Demographics
NPI:1376036400
Name:VIAFARA, FREDDY (LPC)
Entity Type:Individual
Prefix:
First Name:FREDDY
Middle Name:
Last Name:VIAFARA
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 1:1515 HYDE PARK BLVD UNIT 6
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-2539
Mailing Address - Country:US
Mailing Address - Phone:713-478-6052
Mailing Address - Fax:
Practice Address - Street 1:3730 KIRBY DR STE 904
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3994
Practice Address - Country:US
Practice Address - Phone:832-484-2635
Practice Address - Fax:832-202-2479
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73589101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty