Provider Demographics
NPI:1821538679
Name:SANCHEZ, MARY CAROLINE (LPC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CAROLINE
Last Name:SANCHEZ
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 1:10530 BILLBROOK PL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2357
Mailing Address - Country:US
Mailing Address - Phone:512-565-5268
Mailing Address - Fax:
Practice Address - Street 1:1715 FM 1626
Practice Address - Street 2:#102
Practice Address - City:MANCHACA
Practice Address - State:TX
Practice Address - Zip Code:78652-3553
Practice Address - Country:US
Practice Address - Phone:512-280-5315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76040172V00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No172V00000XOther Service ProvidersCommunity Health Worker