Provider Demographics
NPI:1740092154
Name:BENAVIDES, MAGDALENA (LPCA)
Entity type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:BENAVIDES
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25145 STAR LN STE 303
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7087
Mailing Address - Country:US
Mailing Address - Phone:281-984-3494
Mailing Address - Fax:
Practice Address - Street 1:11777 KATY FWY STE 350
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1721
Practice Address - Country:US
Practice Address - Phone:713-365-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93547101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional