Provider Demographics
NPI:1821801473
Name:PEREZ, ESTELLA MARIE (LPC-A)
Entity type:Individual
Prefix:
First Name:ESTELLA
Middle Name:MARIE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 W IROQUOIS AVE
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-9675
Mailing Address - Country:US
Mailing Address - Phone:956-601-4014
Mailing Address - Fax:
Practice Address - Street 1:1101 VINE AVE STE A&B
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4079
Practice Address - Country:US
Practice Address - Phone:956-451-1673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97363101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health