Provider Demographics
NPI:1407111453
Name:ESCOBAR, FATIMAH I (LPC-I, CI)
Entity Type:Individual
Prefix:MRS
First Name:FATIMAH
Middle Name:I
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:LPC-I, CI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18219 FLINT HILL DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-8494
Mailing Address - Country:US
Mailing Address - Phone:832-752-1910
Mailing Address - Fax:
Practice Address - Street 1:18219 FLINT HILL DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-8494
Practice Address - Country:US
Practice Address - Phone:832-752-1910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
TX67476101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)