Provider Demographics
NPI:1184153389
Name:MEDINA, FILIBERTO ARTURO (LPC)
Entity type:Individual
Prefix:
First Name:FILIBERTO
Middle Name:ARTURO
Last Name:MEDINA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:FILIBERTO
Other - Middle Name:ARTURO
Other - Last Name:MEDINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASOTP
Mailing Address - Street 1:304 INSIDER LOOP
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:TX
Mailing Address - Zip Code:78621-2539
Mailing Address - Country:US
Mailing Address - Phone:786-873-8290
Mailing Address - Fax:
Practice Address - Street 1:2312 WESTERN TRAILS BLVD STE 402
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1642
Practice Address - Country:US
Practice Address - Phone:512-777-2686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2022-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLCC05-8975101YP1600X
TX85238.101YP2500X
FLIMH-20192101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health