Provider Demographics
NPI:1629362314
Name:LONGORIA-CARTER, VANESSA LYNN (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:LYNN
Last Name:LONGORIA-CARTER
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 SCHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210-4353
Mailing Address - Country:US
Mailing Address - Phone:502-386-7462
Mailing Address - Fax:
Practice Address - Street 1:201 S LAKELINE BLVD
Practice Address - Street 2:103
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2718
Practice Address - Country:US
Practice Address - Phone:512-537-3093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY276228101YP2500X
TX201630106H00000X
TX65805101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist