Provider Demographics
NPI:1245441724
Name:O'HARE-SERRANO, SYLVIA L (LPC)
Entity type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:L
Last Name:O'HARE-SERRANO
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 1:9434 VISCOUNT BLVD
Mailing Address - Street 2:STE 134
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7057
Mailing Address - Country:US
Mailing Address - Phone:915-867-7567
Mailing Address - Fax:877-606-9254
Practice Address - Street 1:9434 VISCOUNT BLVD
Practice Address - Street 2:STE 134
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7057
Practice Address - Country:US
Practice Address - Phone:915-867-7567
Practice Address - Fax:877-587-9452
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58236101Y00000X
TX26127104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187181603Medicaid