Provider Demographics
NPI:1528882784
Name:CONTRERAS, EDGAR ARMANDO JR (LCSW)
Entity type:Individual
Prefix:
First Name:EDGAR
Middle Name:ARMANDO
Last Name:CONTRERAS
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-2229
Mailing Address - Country:US
Mailing Address - Phone:972-502-4003
Mailing Address - Fax:
Practice Address - Street 1:201 E 9TH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-2229
Practice Address - Country:US
Practice Address - Phone:972-502-4003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX689841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical