Healthcare Provider Details

I. General information

NPI: 1356594394
Provider Name (Legal Business Name): VERONICA BENAVIDEZ MEJIA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12801 N CENTRAL EXPY STE 510
DALLAS TX
75243-1842
US

IV. Provider business mailing address

PO BOX 1466
SABINAL TX
78881-1466
US

V. Phone/Fax

Practice location:
  • Phone: 210-284-3544
  • Fax:
Mailing address:
  • Phone: 210-284-3544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number62641
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: