Provider Demographics
NPI:1437196060
Name:MALDONADO, HUMBERTO MAX (LPC)
Entity Type:Individual
Prefix:MR
First Name:HUMBERTO
Middle Name:MAX
Last Name:MALDONADO
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 1:326 JEANETTE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7415
Mailing Address - Country:US
Mailing Address - Phone:210-829-8330
Mailing Address - Fax:210-829-4925
Practice Address - Street 1:326 JEANETTE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7415
Practice Address - Country:US
Practice Address - Phone:210-829-8330
Practice Address - Fax:210-829-4925
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7510101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional