MEDICARE: MRS. ESMERALDA DELGADILLO LPC, CCSAS

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	101YP1600X	Pastoral Counselor		TX
2	101YP2500X	Professional Counselor	78269	TX

General Provider Information

NPI Number	:	1407481419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ESMERALDA DELGADILLO LPC, CCSAS

Provider Business Mailing Address
First Line	:	19414 CLIMBING OAKS DR
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-2915
Country	:	US
Telephone Number	:	346-279-9285
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 ROCKMEAD DR STE 246
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-2106
Country	:	US
Telephone Number	:	281-913-5438
Fax Number	:	281-359-3544

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

Provider Enumeration Date	:	03/10/2020
Last Update Date	:	03/10/2020

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