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General NPI Number Information
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NPI Number | 1235746025
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Entity Type | Individual
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Provider Name | AUDREY ALEXANDER JOLIVETTE LPC
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Gender | Female
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Dates
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Enumeration Date | 09/26/2020
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 10730 POTRANCO RD STE 122-475
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City | SAN ANTONIO
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State | TX
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Zip | 78251-3327
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Country | US
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Telephone | 210-379-7313
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Fax |
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Provider Business Mailing Address
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Address Line | 10730 POTRANCO RD STE 122-475
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City | SAN ANTONIO
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State | TX
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Zip | 78251-3327
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Country | US
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Telephone | 210-505-7024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 81969
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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 | 81969
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License Number State | TX
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