Provider Demographics
NPI:1750038311
Name:IBARRECHE EGANA, NEREA (MED, LCDC)
Entity Type:Individual
Prefix:
First Name:NEREA
Middle Name:
Last Name:IBARRECHE EGANA
Suffix:
Gender:F
Credentials:MED, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 RESEARCH FOREST DR APT 4305
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1572
Mailing Address - Country:US
Mailing Address - Phone:832-361-8773
Mailing Address - Fax:
Practice Address - Street 1:8101 RESEARCH FOREST DR APT 4305
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-1572
Practice Address - Country:US
Practice Address - Phone:832-361-8773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 174H00000X
TX15549101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174H00000XOther Service ProvidersHealth Educator