Provider Demographics
NPI:1942679345
Name:ESPINOSA, SAMMY (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:SAMMY
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 64TH
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-5110
Mailing Address - Country:US
Mailing Address - Phone:806-773-1966
Mailing Address - Fax:806-797-7101
Practice Address - Street 1:2402 52ND STREET, SUITE #6
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-2548
Practice Address - Country:US
Practice Address - Phone:806-773-7100
Practice Address - Fax:806-797-7101
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor