Healthcare Provider Details

I. General information

NPI: 1114649704
Provider Name (Legal Business Name): IVON HERRERA LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 BILLINGS ST STE 510
ARLINGTON TX
76010-5401
US

IV. Provider business mailing address

201 BILLINGS ST STE 510
ARLINGTON TX
76010-5401
US

V. Phone/Fax

Practice location:
  • Phone: 817-583-6500
  • Fax:
Mailing address:
  • Phone: 817-583-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number81626
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: