Provider Demographics
NPI:1356797641
Name:VELA, JOANNA (LCDC, LPC)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:VELA
Suffix:
Gender:F
Credentials:LCDC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10615 PERRIN BEITEL RD STE 802
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-3142
Mailing Address - Country:US
Mailing Address - Phone:210-267-1665
Mailing Address - Fax:800-508-0086
Practice Address - Street 1:21802 BROKEN ELM
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-2282
Practice Address - Country:US
Practice Address - Phone:210-267-1665
Practice Address - Fax:800-508-0086
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12076101YA0400X
TX69058101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health