Provider Demographics
NPI:1255421566
Name:SAENZ, RAY (LCSW)
Entity type:Individual
Prefix:
First Name:RAY
Middle Name:
Last Name:SAENZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:RAY
Other - Middle Name:
Other - Last Name:SAENZ-LARRASQUITU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1001 LOUISIANA AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2862
Mailing Address - Country:US
Mailing Address - Phone:361-853-9998
Mailing Address - Fax:361-855-6696
Practice Address - Street 1:1001 LOUISIANA AVE STE 302
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2862
Practice Address - Country:US
Practice Address - Phone:361-853-9998
Practice Address - Fax:361-855-6696
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10937104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX064269601Medicaid
TX064269602Medicaid
TXSW00S89GAMedicaid
TXS89GMedicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER