Provider Demographics
NPI:1376654335
Name:JUAREZ, EDUARDO (MA, LPC)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:JUAREZ
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 PENNBROOK PKWY STE 208
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-3843
Mailing Address - Country:US
Mailing Address - Phone:267-217-7065
Mailing Address - Fax:267-217-7607
Practice Address - Street 1:280 PENNBROOK PKWY STE 208
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-3843
Practice Address - Country:US
Practice Address - Phone:267-217-7065
Practice Address - Fax:267-217-7607
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004248101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health