Provider Demographics
NPI:1740376300
Name:MARCEL, SAMUEL (LPC)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:
Last Name:MARCEL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 N LEE TREVINO DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4545
Mailing Address - Country:US
Mailing Address - Phone:915-613-0030
Mailing Address - Fax:915-594-7101
Practice Address - Street 1:1790 N LEE TREVINO DR
Practice Address - Street 2:SUITE 203
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-4545
Practice Address - Country:US
Practice Address - Phone:915-613-0030
Practice Address - Fax:915-594-7101
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18932101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84599LOtherBCBS OF TEXAS
NMNM600035OtherVALUE OPTIONS
NMNM600035OtherVALUE OPTIONS