Healthcare Provider Details

I. General information

NPI: 1407481419
Provider Name (Legal Business Name): ESMERALDA DELGADILLO LPC, CCSAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2020
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 ROCKMEAD DR STE 246
KINGWOOD TX
77339-2106
US

IV. Provider business mailing address

19414 CLIMBING OAKS DR
HUMBLE TX
77346-2915
US

V. Phone/Fax

Practice location:
  • Phone: 281-913-5438
  • Fax: 281-359-3544
Mailing address:
  • Phone: 346-279-9285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number78269
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: