Provider Demographics
NPI:1629208186
Name:MENDOZA, ERIN L (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:L
Last Name:MENDOZA
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 1:261 MISTLETOE LN
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-5546
Mailing Address - Country:US
Mailing Address - Phone:512-576-4662
Mailing Address - Fax:
Practice Address - Street 1:261 MISTLETOE LN
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-5546
Practice Address - Country:US
Practice Address - Phone:512-576-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-18
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TX63277101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health