Healthcare Provider Details

I. General information

NPI: 1144997917
Provider Name (Legal Business Name): ERIKA JASMIN ESQUIVEL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S LAMAR BLVD STE 15
AUSTIN TX
78704-4789
US

IV. Provider business mailing address

6812 FELIPE DR
AUSTIN TX
78747-6802
US

V. Phone/Fax

Practice location:
  • Phone: 956-821-6419
  • Fax:
Mailing address:
  • Phone: 956-821-6419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number80124
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: