Provider Demographics
NPI:1538605878
Name:LARA, ALEXANDRIA (MED,LPC)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:LARA
Suffix:
Gender:F
Credentials:MED,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 MCDAVITT BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2137
Mailing Address - Country:US
Mailing Address - Phone:956-909-2923
Mailing Address - Fax:
Practice Address - Street 1:744 MCDAVITT BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2137
Practice Address - Country:US
Practice Address - Phone:956-909-2923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73588101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional