Provider Demographics
NPI:1669073037
Name:LIFEHOUSE PROFESSIONAL COUNSELING PLLC
Entity type:Organization
Organization Name:LIFEHOUSE PROFESSIONAL COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC-S/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROXANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, CTRS
Authorized Official - Phone:956-602-0117
Mailing Address - Street 1:6602 POLARIS DR.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-2082
Mailing Address - Country:US
Mailing Address - Phone:956-285-4962
Mailing Address - Fax:
Practice Address - Street 1:6602 POLARIS DR STE 1
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-2082
Practice Address - Country:US
Practice Address - Phone:956-602-0117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty