MEDICARE: LESLLY A BLANCAS 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	89938	TX

General Provider Information

NPI Number	:	1578270526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLLY A BLANCAS LPC

Provider Business Mailing Address
First Line	:	1408 PETRI DR UNIT 2
Second Line	:
City	:	WESLACO
State	:	TX
Zip	:	78599-1942
Country	:	US
Telephone Number	:	956-998-2063
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 E TYLER AVE
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550
Country	:	US
Telephone Number	:	956-423-1194
Fax Number	:

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

Provider Enumeration Date	:	10/31/2022
Last Update Date	:	03/10/2026

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