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General NPI Number Information
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NPI Number | 1821538679
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Entity Type | Individual
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Provider Name | MARY CAROLINE SANCHEZ LPC
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Gender | Female
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Dates
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Enumeration Date | 02/27/2017
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Last Update Date | 06/19/2021
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Provider Practice Location Address
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Address Line | 1715 FM 1626 #102
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City | MANCHACA
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State | TX
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Zip | 78652-3553
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Country | US
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Telephone | 512-280-5315
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Fax |
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Provider Business Mailing Address
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Address Line | 10530 BILLBROOK PL
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City | AUSTIN
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State | TX
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Zip | 78748-2357
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Country | US
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Telephone | 512-565-5268
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 76040
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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 | 76040
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License Number State | TX
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