Provider Demographics
NPI:1952811549
Name:SIMENTAL, MARCY ELIZABETH (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARCY
Middle Name:ELIZABETH
Last Name:SIMENTAL
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 1:3961 TIERRA LIRIO PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-5347
Mailing Address - Country:US
Mailing Address - Phone:915-345-2281
Mailing Address - Fax:
Practice Address - Street 1:2990 TRAWOOD DR APT 19G
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-4236
Practice Address - Country:US
Practice Address - Phone:915-345-2281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-09
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
TX87089101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician