Provider Demographics
NPI:1790491553
Name:ESPINOSA, CAROLE JO (LPC-A)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:JO
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4733 SIR GARETH DR # B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1205
Mailing Address - Country:US
Mailing Address - Phone:915-313-1033
Mailing Address - Fax:
Practice Address - Street 1:4733 SIR GARETH DR # B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1205
Practice Address - Country:US
Practice Address - Phone:915-313-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88097101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health