Healthcare Provider Details

I. General information

NPI: 1497137004
Provider Name (Legal Business Name): LILIANA VACIO LPC-S, LCDC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9434 VISCOUNT BLVD STE 234
EL PASO TX
79925
US

IV. Provider business mailing address

5529 BETH VIEW DR
EL PASO TX
79932-1418
US

V. Phone/Fax

Practice location:
  • Phone: 915-799-0747
  • Fax: 915-591-2990
Mailing address:
  • Phone: 915-299-3134
  • Fax: 915-591-2990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12568
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number74987
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: