Provider Demographics
NPI:1821759424
Name:EDWARD SALAZAR
Entity Type:Organization
Organization Name:EDWARD SALAZAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:210-323-7707
Mailing Address - Street 1:4729 GREEN BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3043
Mailing Address - Country:US
Mailing Address - Phone:210-323-7707
Mailing Address - Fax:
Practice Address - Street 1:8555 E LOOP 1604 N
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2915
Practice Address - Country:US
Practice Address - Phone:210-323-7707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty