Healthcare Provider Details

I. General information

NPI: 1861149130
Provider Name (Legal Business Name): LACRESA LOVE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LACRESA MARTIN

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3232 N LOCUST ST APT 311
DENTON TX
76207-7486
US

IV. Provider business mailing address

3232 N LOCUST ST APT 311
DENTON TX
76207-7486
US

V. Phone/Fax

Practice location:
  • Phone: 469-810-5875
  • Fax:
Mailing address:
  • Phone: 469-810-5875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number88196
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: