Provider Demographics
NPI:1013573922
Name:ELIZONDO, ANA ISEL (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:ISEL
Last Name:ELIZONDO
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 1:5401 N 28TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4777
Mailing Address - Country:US
Mailing Address - Phone:956-821-7499
Mailing Address - Fax:
Practice Address - Street 1:5401 N 28TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4777
Practice Address - Country:US
Practice Address - Phone:956-821-7499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76772101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional