Provider Demographics
NPI:1548753627
Name:GINER-NEVAREZ, MARICELA (LPC)
Entity Type:Individual
Prefix:
First Name:MARICELA
Middle Name:
Last Name:GINER-NEVAREZ
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 1:13021 JORGE GRAJEDA
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-7481
Mailing Address - Country:US
Mailing Address - Phone:915-920-5110
Mailing Address - Fax:
Practice Address - Street 1:6314 DELTA DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-5406
Practice Address - Country:US
Practice Address - Phone:915-497-7429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76515101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional