Provider Demographics
NPI:1245820638
Name:MENDEZ, LORENA (MS, LPC-S, RPT-S)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:MS, LPC-S, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 ARSHIA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-5602
Mailing Address - Country:US
Mailing Address - Phone:361-563-7611
Mailing Address - Fax:
Practice Address - Street 1:2525 ARSHIA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-5602
Practice Address - Country:US
Practice Address - Phone:361-563-7611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62682101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional