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General NPI Number Information
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NPI Number | 1235008400
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL COUNSELING, SUPERVISION & CONSULTATION
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 212 MELICENT ST
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City | EL PASO
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State | TX
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Zip | 79912-2114
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Country | US
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Telephone | 915-270-7107
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Fax |
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Provider Business Mailing Address
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Address Line | 212 MELICENT ST
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City | EL PASO
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State | TX
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Zip | 79912-2114
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Country | US
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Telephone | 915-270-7107
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MANUELA ELIZABETH LUGO MUNOZ
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Credential | LPC-S
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Telephone | 915-255-8754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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