Provider Demographics
NPI:1407471865
Name:ELIZONDO, JAZMIN (LPC)
Entity Type:Individual
Prefix:
First Name:JAZMIN
Middle Name:
Last Name:ELIZONDO
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 1:2208 N 46TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-3649
Mailing Address - Country:US
Mailing Address - Phone:956-451-9289
Mailing Address - Fax:
Practice Address - Street 1:713 E ESPERANZA AVE STE B
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-1448
Practice Address - Country:US
Practice Address - Phone:956-413-7005
Practice Address - Fax:956-277-9489
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79080101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor