Healthcare Provider Details

I. General information

NPI: 1609515246
Provider Name (Legal Business Name): ANAMARISA DAVIS CUELLAR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W RALPH HALL PKWY STE 112
ROCKWALL TX
75032-6690
US

IV. Provider business mailing address

25500 TWO CREEKS APT 1902
SAN ANTONIO TX
78255-2508
US

V. Phone/Fax

Practice location:
  • Phone: 972-865-8782
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number96809
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0018642
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: