Provider Demographics
NPI:1962816363
Name:ACOSTA, CRISTAL MARTINEZ (LPC-S, NCC)
Entity Type:Individual
Prefix:MRS
First Name:CRISTAL
Middle Name:MARTINEZ
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:LPC-S, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W OVERLAND AVE STE 250-JJ
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79901-1085
Mailing Address - Country:US
Mailing Address - Phone:915-201-0244
Mailing Address - Fax:
Practice Address - Street 1:500 W OVERLAND AVE STE 250-JJ
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901-1085
Practice Address - Country:US
Practice Address - Phone:915-995-5586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69725101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional