Provider Demographics
NPI:1841941259
Name:LEOS, CARINA LARITSA (MS, LPC)
Entity type:Individual
Prefix:
First Name:CARINA
Middle Name:LARITSA
Last Name:LEOS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3616 S RHONDA ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3135
Mailing Address - Country:US
Mailing Address - Phone:956-329-3844
Mailing Address - Fax:
Practice Address - Street 1:3616 S RHONDA ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3135
Practice Address - Country:US
Practice Address - Phone:956-329-3844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83203101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health