Provider Demographics
NPI:1720730922
Name:JIMENEZ-BALDERAS, YENIT (LPC)
Entity Type:Individual
Prefix:MRS
First Name:YENIT
Middle Name:
Last Name:JIMENEZ-BALDERAS
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 1:7911 CRYSTAL MOON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6060
Mailing Address - Country:US
Mailing Address - Phone:832-971-8906
Mailing Address - Fax:
Practice Address - Street 1:7911 CRYSTAL MOON DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6060
Practice Address - Country:US
Practice Address - Phone:832-971-8906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional