Provider Demographics
NPI:1184929879
Name:RECINOS, MARIAJOSE (MS,LPC)
Entity type:Individual
Prefix:MRS
First Name:MARIAJOSE
Middle Name:
Last Name:RECINOS
Suffix:
Gender:F
Credentials:MS,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9132 WEBB KAY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6233
Mailing Address - Country:US
Mailing Address - Phone:214-288-3499
Mailing Address - Fax:
Practice Address - Street 1:6510 ABRAMS RD STE 402
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-7214
Practice Address - Country:US
Practice Address - Phone:972-807-2301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2015-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65134101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX65134Medicaid
TX65134Medicaid