Provider Demographics
NPI:1144625575
Name:BENEZRA, MARIA MERCEDES (MA LPC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MERCEDES
Last Name:BENEZRA
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:M
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8814 ARAPAHOE PASS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3386
Mailing Address - Country:US
Mailing Address - Phone:832-475-7126
Mailing Address - Fax:
Practice Address - Street 1:20151 EMERALD MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4185
Practice Address - Country:US
Practice Address - Phone:832-475-7126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69866101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional