Provider Demographics
NPI:1932676939
Name:TREVINO, ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:TREVINO
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 1:503 CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHINA SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:76633-3577
Mailing Address - Country:US
Mailing Address - Phone:254-644-2827
Mailing Address - Fax:
Practice Address - Street 1:503 CEDAR RIDGE DR
Practice Address - Street 2:503 CEDAR RIDGE DR
Practice Address - City:CHINA SPRING
Practice Address - State:TX
Practice Address - Zip Code:76633
Practice Address - Country:US
Practice Address - Phone:254-644-2827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-28
Last Update Date:2018-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73646101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional