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General NPI Number Information
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NPI Number | 1619869435
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Entity Type | Organization
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Legal Business Name | RENACER COUNSELING LLC
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 1740 BOCA CHICA BLVD STE 200A
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City | BROWNSVILLE
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State | TX
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Zip | 78520-8132
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Country | US
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Telephone | 956-346-0418
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Fax |
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Provider Business Mailing Address
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Address Line | 1740 BOCA CHICA BLVD STE 200
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City | BROWNSVILLE
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State | TX
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Zip | 78520-8132
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Country | US
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Telephone | 956-346-0418
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Fax |
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Authorized Official
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Title or Position | OWNER / CLINICAL DIRECTOR
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Name | ROXANA CASIANO MALDONADO
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Credential | LPC
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Telephone | 956-346-0418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NULL
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