Provider Demographics
NPI:1669068946
Name:CONTRERAS, JACQUELINE (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12127 FAITHCREST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5498
Mailing Address - Country:US
Mailing Address - Phone:210-570-0818
Mailing Address - Fax:
Practice Address - Street 1:5835 CALLAGHAN RD STE 305
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1132
Practice Address - Country:US
Practice Address - Phone:210-570-0818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79487101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health