Provider Demographics
NPI:1700829736
Name:AGUIRRE, DAVID (MED, LPC, LMFT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:AGUIRRE
Suffix:
Gender:M
Credentials:MED, 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:BLDG. 2487 CARRINGTON RD.
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79906
Mailing Address - Country:US
Mailing Address - Phone:915-742-3014
Mailing Address - Fax:
Practice Address - Street 1:BLDG. 2487 CARRINGTON RD.
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79906
Practice Address - Country:US
Practice Address - Phone:915-742-3014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4071106H00000X
NM54628101Y00000X, 101Y00000X
TX11287101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095322605Medicaid
741204335OtherFEDERAL TAX ID
TX80964LOtherBCBS