Provider Demographics
NPI:1376863175
Name:PEREZ, ABIGAIL CHAPA (LPC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:CHAPA
Last Name:PEREZ
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 1:3013 109TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-6715
Mailing Address - Country:US
Mailing Address - Phone:806-441-8919
Mailing Address - Fax:
Practice Address - Street 1:2032 82ND ST
Practice Address - Street 2:STE 104
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-6715
Practice Address - Country:US
Practice Address - Phone:806-441-8919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63983101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health