Provider Demographics
NPI:1497137004
Name:VACIO, LILIANA (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:VACIO
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9434 VISCOUNT BLVD STE 234
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7053
Mailing Address - Country:US
Mailing Address - Phone:915-799-0747
Mailing Address - Fax:915-591-2990
Practice Address - Street 1:9434 VISCOUNT BLVD STE 234
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925
Practice Address - Country:US
Practice Address - Phone:915-799-0747
Practice Address - Fax:915-591-2990
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12568101YA0400X
TX74987101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)