Provider Demographics
NPI:1962869586
Name:ZAVALA CERVANTES, ALEJANDRO (MS, LPC)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:ZAVALA CERVANTES
Suffix:
Gender:M
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 1:1302 CARDIGAN ST
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-3210
Mailing Address - Country:US
Mailing Address - Phone:972-529-8264
Mailing Address - Fax:
Practice Address - Street 1:1302 CARDIGAN ST
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-3210
Practice Address - Country:US
Practice Address - Phone:972-529-8264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70268101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health