Provider Demographics
NPI:1902815582
Name:PINON, GRACIELA IRENE (LPC)
Entity Type:Individual
Prefix:MS
First Name:GRACIELA
Middle Name:IRENE
Last Name:PINON
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 1:905 NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4739
Mailing Address - Country:US
Mailing Address - Phone:915-543-4933
Mailing Address - Fax:915-544-7080
Practice Address - Street 1:905 NOBLE ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4739
Practice Address - Country:US
Practice Address - Phone:915-543-4933
Practice Address - Fax:915-544-7080
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02726101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7047LCOtherBLUE CROSS BLUE SHIELD