Provider Demographics
NPI:1841829199
Name:PRESLEY, TRACI CELESTE (LPC)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:CELESTE
Last Name:PRESLEY
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 1:444 E ROBINSON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2602
Mailing Address - Country:US
Mailing Address - Phone:915-588-9901
Mailing Address - Fax:
Practice Address - Street 1:444 E ROBINSON AVE STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2602
Practice Address - Country:US
Practice Address - Phone:915-588-9901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72216101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional