Provider Demographics
NPI:1922127638
Name:MENDOZA-GIBSON, LORENA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LORENA
Middle Name:
Last Name:MENDOZA-GIBSON
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 1:7722 N LOOP DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-2907
Mailing Address - Country:US
Mailing Address - Phone:915-782-4023
Mailing Address - Fax:915-781-1341
Practice Address - Street 1:7722 N LOOP DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-2907
Practice Address - Country:US
Practice Address - Phone:915-782-4023
Practice Address - Fax:915-781-1341
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60693101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183338601Medicaid
TX60693OtherLPC