Provider Demographics
NPI:1841699097
Name:HUERTA, ADELA (MS, CRC, LPC INTERN)
Entity type:Individual
Prefix:
First Name:ADELA
Middle Name:
Last Name:HUERTA
Suffix:
Gender:F
Credentials:MS, CRC, LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E GREG DR
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-9137
Mailing Address - Country:US
Mailing Address - Phone:956-874-9154
Mailing Address - Fax:
Practice Address - Street 1:345 E GREG DR
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-9137
Practice Address - Country:US
Practice Address - Phone:956-874-9154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2018-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78746101Y00000X
TXAHUERTA11174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialist
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty