Provider Demographics
NPI:1659798528
Name:ROBLES, ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ROBLES
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 1:6090 SURETY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2041
Mailing Address - Country:US
Mailing Address - Phone:915-329-1119
Mailing Address - Fax:915-881-4959
Practice Address - Street 1:6090 SURETY DR STE 200
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2041
Practice Address - Country:US
Practice Address - Phone:915-329-1119
Practice Address - Fax:915-881-4959
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69452101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX331730701Medicaid