Provider Demographics
NPI:1780408872
Name:MORALES, JACQUELYN ROSE (LPC ASSOOCIATE)
Entity type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:ROSE
Last Name:MORALES
Suffix:
Gender:F
Credentials:LPC ASSOOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3616 ROBIN AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5553
Mailing Address - Country:US
Mailing Address - Phone:956-529-1341
Mailing Address - Fax:
Practice Address - Street 1:3616 ROBIN AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-5553
Practice Address - Country:US
Practice Address - Phone:956-529-1341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97122101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health