Healthcare Provider Details

I. General information

NPI: 1447041058
Provider Name (Legal Business Name): DOMINIQUE HOPE CUELLAR NCC, LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 ENNIS JOSLIN RD APT 524
CORPUS CHRISTI TX
78412-4376
US

IV. Provider business mailing address

1701 ENNIS JOSLIN RD APT 524
CORPUS CHRISTI TX
78412-4376
US

V. Phone/Fax

Practice location:
  • Phone: 512-906-8178
  • Fax:
Mailing address:
  • Phone: 512-906-8718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: