Provider Demographics
NPI:1013583376
Name:GARCILAZO, RAQUEL ANN (LPC)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:ANN
Last Name:GARCILAZO
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E FERN AVE STE 139
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1524
Mailing Address - Country:US
Mailing Address - Phone:956-226-0765
Mailing Address - Fax:
Practice Address - Street 1:801 E FERN AVE STE 139
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-1524
Practice Address - Country:US
Practice Address - Phone:956-226-0765
Practice Address - Fax:956-448-5193
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81996171M00000X, 251B00000X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty