Provider Demographics
NPI:1417849522
Name:DOMINGUEZ, CHRISTIAN NOEL (LPC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIAN
Middle Name:NOEL
Last Name:DOMINGUEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4414 SWAN FRST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-4900
Mailing Address - Country:US
Mailing Address - Phone:210-831-0790
Mailing Address - Fax:
Practice Address - Street 1:19115 NACOGDOCHES ROAD
Practice Address - Street 2:SUITE #12
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78266
Practice Address - Country:US
Practice Address - Phone:361-248-8232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91373101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health