Provider Demographics
NPI:1003611708
Name:GANEV, ALYSSA (LPC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:GANEV
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9542 AQUA VERDE
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4130
Mailing Address - Country:US
Mailing Address - Phone:210-705-3608
Mailing Address - Fax:
Practice Address - Street 1:10607 LIBERTY FLD # 107
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-6405
Practice Address - Country:US
Practice Address - Phone:210-816-4353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90386101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional