Healthcare Provider Details

I. General information

NPI: 1831996768
Provider Name (Legal Business Name): MARIA E CARRION-GOMEZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA E CARRION

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 W MARTIN ST # MS 49-2
SAN ANTONIO TX
78207-0903
US

IV. Provider business mailing address

903 W MARTIN ST
SAN ANTONIO TX
78207-0903
US

V. Phone/Fax

Practice location:
  • Phone: 210-358-8255
  • Fax: 210-644-8625
Mailing address:
  • Phone: 210-358-5909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number19912
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: