Healthcare Provider Details

I. General information

NPI: 1013489855
Provider Name (Legal Business Name): ISABELLE BERNADETTE DUQUE DE ESTRADA NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2018
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 GUADALUPE ST STE 260
AUSTIN TX
78705-5654
US

IV. Provider business mailing address

2021 GUADALUPE ST STE 260
AUSTIN TX
78705-5654
US

V. Phone/Fax

Practice location:
  • Phone: 844-843-7279
  • Fax:
Mailing address:
  • Phone: 844-843-7279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number77105
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: