Healthcare Provider Details

I. General information

NPI: 1629208186
Provider Name (Legal Business Name): ERIN L MENDOZA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2009
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 MISTLETOE LN
KYLE TX
78640-5546
US

IV. Provider business mailing address

261 MISTLETOE LN
KYLE TX
78640-5546
US

V. Phone/Fax

Practice location:
  • Phone: 512-576-4662
  • Fax:
Mailing address:
  • Phone: 512-693-7734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number63277
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: