Provider Demographics
NPI:1376125724
Name:MENDICUTI, MARIA DE LOURDES (MS LPC NCC)
Entity Type:Individual
Prefix:
First Name:MARIA DE LOURDES
Middle Name:
Last Name:MENDICUTI
Suffix:
Gender:F
Credentials:MS LPC NCC
Other - Prefix:
Other - First Name:LOURDES
Other - Middle Name:
Other - Last Name:MENDICUTI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC, NCC
Mailing Address - Street 1:2113 OATFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-1494
Mailing Address - Country:US
Mailing Address - Phone:832-245-4590
Mailing Address - Fax:
Practice Address - Street 1:2113 OATFIELD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-1494
Practice Address - Country:US
Practice Address - Phone:832-245-4590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80111101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health