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General NPI Number Information
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NPI Number | 1073824116
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Entity Type | Organization
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Legal Business Name | VALLEY BEHAVIORAL CENTER FOR COUNSELING, PLLC
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 318 N 15TH ST
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City | MCALLEN
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State | TX
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Zip | 78501-4706
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Country | US
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Telephone | 956-517-9232
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Fax | 956-627-4297
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Provider Business Mailing Address
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Address Line | 318 N 15TH ST
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City | MCALLEN
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State | TX
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Zip | 78501-4706
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Country | US
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Telephone | 956-517-9232
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Fax | 956-627-4297
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Authorized Official
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Title or Position | OWNER, DIRECTOR
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Name | MISS CRISTINA LARA
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Credential | LPC, MA
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Telephone | 956-517-9232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 16535
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 63732
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License Number State | TX
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