Provider Demographics
NPI:1700031564
Name:LOU VALDEZ MA LPC PLLC
Entity Type:Organization
Organization Name:LOU VALDEZ MA LPC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:LOU
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-525-0202
Mailing Address - Street 1:6609 BLANCO RD STE 157
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6157
Mailing Address - Country:US
Mailing Address - Phone:210-525-0202
Mailing Address - Fax:210-525-0232
Practice Address - Street 1:6609 BLANCO RD STE 157
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6157
Practice Address - Country:US
Practice Address - Phone:210-525-0202
Practice Address - Fax:210-252-0232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60956101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182027601Medicaid