Provider Demographics
NPI:1457174880
Name:BARRAZA, KAREN ILEANA (LPCC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ILEANA
Last Name:BARRAZA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 EDITH DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-4114
Mailing Address - Country:US
Mailing Address - Phone:915-637-4342
Mailing Address - Fax:
Practice Address - Street 1:10 MCGREGOR RANGE RD
Practice Address - Street 2:
Practice Address - City:CHAPARRAL
Practice Address - State:NM
Practice Address - Zip Code:88081-7753
Practice Address - Country:US
Practice Address - Phone:575-824-4884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2024-0683101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health