Provider Demographics
NPI:1558380519
Name:NANCE, LOIS L (LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:L
Last Name:NANCE
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 MONTANA AVE
Mailing Address - Street 2:STE L
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5617
Mailing Address - Country:US
Mailing Address - Phone:915-587-1097
Mailing Address - Fax:915-587-1094
Practice Address - Street 1:1401 MONTANA AVE
Practice Address - Street 2:STE L
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5617
Practice Address - Country:US
Practice Address - Phone:915-587-1097
Practice Address - Fax:915-587-1094
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10419101YA0400X, 101YM0800X, 101YP2500X
TX002988-041563106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7101LCOtherBCBS #
TX710985228OtherTAX ID #
TX1747214-01Medicaid