Provider Demographics
NPI:1255643425
Name:LONGORIA, LEONEL (MS, LPC)
Entity type:Individual
Prefix:MR
First Name:LEONEL
Middle Name:
Last Name:LONGORIA
Suffix:
Gender:M
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 1:1224 ESPERANZA ST
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-8226
Mailing Address - Country:US
Mailing Address - Phone:956-854-1255
Mailing Address - Fax:
Practice Address - Street 1:1224 ESPERANZA ST
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-8226
Practice Address - Country:US
Practice Address - Phone:956-854-1255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-05
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64515101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional