Provider Demographics
NPI:1861007452
Name:CORTEZ, DAVID (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:M
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 HUNT LN APT 21311
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4670
Mailing Address - Country:US
Mailing Address - Phone:830-255-7465
Mailing Address - Fax:
Practice Address - Street 1:1210 HUNT LN APT 21311
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4670
Practice Address - Country:US
Practice Address - Phone:830-255-7465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15092101YA0400X
TX81633101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)