MEDICARE: VERONICA BENAVIDEZ MEJIA LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	62641	TX

General Provider Information

NPI Number	:	1356594394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA BENAVIDEZ MEJIA LPC

Provider Business Mailing Address
First Line	:	PO BOX 1466
Second Line	:
City	:	SABINAL
State	:	TX
Zip	:	78881-1466
Country	:	US
Telephone Number	:	210-284-3544
Fax Number	:

Provider Business Practice Location Address
First Line	:	12801 N CENTRAL EXPY STE 510
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-1842
Country	:	US
Telephone Number	:	210-284-3544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	02/21/2023

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