Provider Demographics
NPI:1295094621
Name:AZCARATE, MARISABEL (LPC, LPCC)
Entity type:Individual
Prefix:MRS
First Name:MARISABEL
Middle Name:
Last Name:AZCARATE
Suffix:
Gender:F
Credentials:LPC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3241 TIERRA LUCERO LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4831
Mailing Address - Country:US
Mailing Address - Phone:915-740-7435
Mailing Address - Fax:
Practice Address - Street 1:3241 TIERRA LUCERO LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-4831
Practice Address - Country:US
Practice Address - Phone:915-740-7435
Practice Address - Fax:915-881-4959
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-04
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0140861101YP2500X
TX69927101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional