Provider Demographics
NPI:1376868752
Name:ACOSTA, VENESSA BERNICE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:VENESSA
Middle Name:BERNICE
Last Name:ACOSTA
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 1:27199 BAKER POTTS RD
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-3760
Mailing Address - Country:US
Mailing Address - Phone:956-455-2761
Mailing Address - Fax:956-425-1620
Practice Address - Street 1:27199 BAKER POTTS RD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-3760
Practice Address - Country:US
Practice Address - Phone:956-455-2761
Practice Address - Fax:956-425-1620
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63011101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health