Provider Demographics
NPI:1023592730
Name:GONZALEZ, PRISCILLA ANN (LPC)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:ANN
Last Name:GONZALEZ
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 1:8722 CURLEW ST
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-2850
Mailing Address - Country:US
Mailing Address - Phone:956-200-2818
Mailing Address - Fax:
Practice Address - Street 1:8722 CURLEW ST
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-2850
Practice Address - Country:US
Practice Address - Phone:956-200-2818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2024-10-22
Deactivation Date:2021-03-18
Deactivation Code:
Reactivation Date:2024-10-22
Provider Licenses
StateLicense IDTaxonomies
TX72965101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty