MEDICARE: PROF. CAMILIA LUISA MENDOZA LMFT, LCDC

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	106H00000X	Marriage & Family Therapist	204101	TX
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	14052	TX

General Provider Information

NPI Number	:	1386238376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. CAMILIA LUISA MENDOZA LMFT, LCDC

Provider Business Mailing Address
First Line	:	16306 PINON VISTA DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-7198
Country	:	US
Telephone Number	:	832-598-7253
Fax Number	:

Provider Business Practice Location Address
First Line	:	16306 PINON VISTA DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-7198
Country	:	US
Telephone Number	:	832-598-7253
Fax Number	:

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

Provider Enumeration Date	:	02/22/2021
Last Update Date	:	04/27/2026

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