Provider Demographics
NPI:1720518004
Name:BILBAO, SARA KRISTINA (LPC)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:KRISTINA
Last Name:BILBAO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 N MESA
Mailing Address - Street 2:STE. E #275
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-1670
Mailing Address - Country:US
Mailing Address - Phone:915-584-5105
Mailing Address - Fax:
Practice Address - Street 1:230 THUNDERBIRD DR STE J
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3913
Practice Address - Country:US
Practice Address - Phone:915-479-4041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71362101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional