Provider Demographics
NPI:1730806878
Name:MORENO, BEATRIZ (LPC)
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:MORENO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BEATRIZ
Other - Middle Name:
Other - Last Name:MORENO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1675 OLD CREEK CT
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-1651
Mailing Address - Country:US
Mailing Address - Phone:956-346-0993
Mailing Address - Fax:
Practice Address - Street 1:1675 OLD CREEK CT
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-1651
Practice Address - Country:US
Practice Address - Phone:956-346-0993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TX78039101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
74-2601038OtherIRS