Provider Demographics
NPI:1508640467
Name:LAURENT, ANGELINA THERESA (LPC)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:THERESA
Last Name:LAURENT
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 1:402 N JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-2868
Mailing Address - Country:US
Mailing Address - Phone:956-540-7509
Mailing Address - Fax:956-540-7510
Practice Address - Street 1:402 N JACKSON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-2868
Practice Address - Country:US
Practice Address - Phone:956-540-7509
Practice Address - Fax:956-540-7510
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39916101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional