MEDICARE: ANNE PATRICIA HERNANDEZ LPC, 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	6406	TX
2	101YM0800X	Mental Health Counselor	12643	TX

General Provider Information

NPI Number	:	1518938752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE PATRICIA HERNANDEZ LPC, LCDC

Provider Business Mailing Address
First Line	:	1711 S POLK ST
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79102-3152
Country	:	US
Telephone Number	:	806-372-4357
Fax Number	:	806-372-4355

Provider Business Practice Location Address
First Line	:	1711 S POLK ST
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79102-3152
Country	:	US
Telephone Number	:	806-372-4357
Fax Number	:	806-372-4355

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	09/11/2025

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