Provider Demographics
NPI:1669913067
Name:WESLACO COUNSELING CENTER, PLLC
Entity type:Organization
Organization Name:WESLACO COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:G
Authorized Official - Last Name:UGALDE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:956-520-8700
Mailing Address - Street 1:1009 S UTAH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-5588
Mailing Address - Country:US
Mailing Address - Phone:956-520-8700
Mailing Address - Fax:888-238-8865
Practice Address - Street 1:1009 S UTAH AVE STE A
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-5588
Practice Address - Country:US
Practice Address - Phone:956-520-8700
Practice Address - Fax:888-238-8865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-17
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61413101YP2500X
251B00000X
TX555581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX352979401Medicaid
TX352979401Medicaid