Provider Demographics
NPI:1760072623
Name:RODRIGUEZ CAMPOS, ESMERALDA (LPC)
Entity Type:Individual
Prefix:MS
First Name:ESMERALDA
Middle Name:
Last Name:RODRIGUEZ CAMPOS
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 1:4404 BRAZOS DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-0044
Mailing Address - Country:US
Mailing Address - Phone:956-551-2796
Mailing Address - Fax:
Practice Address - Street 1:30 PROVIDENCIA CT STE 5K
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-7444
Practice Address - Country:US
Practice Address - Phone:956-338-2850
Practice Address - Fax:956-253-4817
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78554101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional