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General NPI Number Information
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NPI Number | 1407581259
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Entity Type | Individual
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Provider Name | VIVIANA PRADO LPC
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Gender | Female
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Dates
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Enumeration Date | 07/17/2022
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Last Update Date | 03/24/2024
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Provider Practice Location Address
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Address Line | 8730 BOEING DR
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City | EL PASO
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State | TX
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Zip | 79925-1228
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Country | US
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Telephone | 915-877-3419
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Fax |
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Provider Business Mailing Address
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Address Line | 201 E MAIN DR STE 600
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City | EL PASO
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State | TX
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Zip | 79901-1385
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 88930
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CBT20230925
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License Number State | NM
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