Provider Demographics
NPI:1982808861
Name:ACOSTA, HOLAYA PONCE (LPC, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:HOLAYA
Middle Name:PONCE
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:LPC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 TRAWOOD, SUITE A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935
Mailing Address - Country:US
Mailing Address - Phone:915-240-4135
Mailing Address - Fax:915-851-7980
Practice Address - Street 1:1851 TRAWOOD, SUITE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935
Practice Address - Country:US
Practice Address - Phone:915-240-4135
Practice Address - Fax:915-851-7980
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59289101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1938953-01Medicaid
TX182595201Medicaid