Provider Demographics
NPI:1407071970
Name:MOLINA, LAZARO ARTURO (LPC)
Entity Type:Individual
Prefix:MR
First Name:LAZARO
Middle Name:ARTURO
Last Name:MOLINA
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 1:12604 TIERRA INCA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4815
Mailing Address - Country:US
Mailing Address - Phone:915-355-1701
Mailing Address - Fax:505-882-1879
Practice Address - Street 1:1275 ANTHONY ROAD
Practice Address - Street 2:SUITE C-7
Practice Address - City:ANTHONY
Practice Address - State:NM
Practice Address - Zip Code:88021
Practice Address - Country:US
Practice Address - Phone:505-882-5290
Practice Address - Fax:505-882-1879
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0097461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health