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General NPI Number Information
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NPI Number | 1790630010
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Entity Type | Organization
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Legal Business Name | LAREDO PSYCHOLOGICAL AND COUNSELING SERVICES
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 6510 POLARIS DR STE 1
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City | LAREDO
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State | TX
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Zip | 78041-2054
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Country | US
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Telephone | 956-431-0402
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Fax |
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Provider Business Mailing Address
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Address Line | 2445 MONARCH DR UNIT 1303
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City | LAREDO
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State | TX
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Zip | 78045-6438
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Country | US
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Telephone | 323-710-4072
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | EDIZA GARCIA
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Credential | PSY.D.
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Telephone | 323-710-4072
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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