Provider Demographics
NPI:1568698082
Name:ROSAS, GERARDO (LPC)
Entity Type:Individual
Prefix:
First Name:GERARDO
Middle Name:
Last Name:ROSAS
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 1:9434 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:915-637-7627
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:79925-7053
Practice Address - Country:US
Practice Address - Phone:915-637-7627
Practice Address - Fax:915-591-2990
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2013-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63565101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional