Healthcare Provider Details

I. General information

NPI: 1144118001
Provider Name (Legal Business Name): PATRICIA TIJERINA LMSW, LCDC-I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5202 VICTORY AVE
EDINBURG TX
78542-8690
US

IV. Provider business mailing address

5202 VICTORY AVE
EDINBURG TX
78542-8690
US

V. Phone/Fax

Practice location:
  • Phone: 956-249-5182
  • Fax:
Mailing address:
  • Phone: 956-249-5182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number109964
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: