MEDICARE: MS. CARMEN ELISA ESTIMBO MS, LPC

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	101YP2500X	Professional Counselor	86997	TX

General Provider Information

NPI Number	:	1699486670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARMEN ELISA ESTIMBO MS, LPC

Provider Business Mailing Address
First Line	:	2005 S MASON RD APT 421
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-5644
Country	:	US
Telephone Number	:	210-589-9738
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 S MASON RD APT 421
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-5644
Country	:	US
Telephone Number	:	210-589-9738
Fax Number	:

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

Provider Enumeration Date	:	12/09/2022
Last Update Date	:	05/27/2026

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