MEDICARE: NANCY LEE CAVAZOS LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	82501	TX
2	101YM0800X	Mental Health Counselor	LC2718	MD
3	101YP2500X	Professional Counselor	LC2718	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043542582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY LEE CAVAZOS LCPC

Provider Business Mailing Address
First Line	:	3207 W ALBERTA RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9635
Country	:	US
Telephone Number	:	956-616-9651
Fax Number	:	956-476-5607

Provider Business Practice Location Address
First Line	:	3207 W ALBERTA RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9635
Country	:	US
Telephone Number	:	956-616-9651
Fax Number	:	956-331-8893

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2010
Last Update Date	:	05/05/2026

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