MEDICARE: MISS ANNABEL MENCHACA 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	17719	TX
2	101YM0800X	Mental Health Counselor	17719	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588679237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ANNABEL MENCHACA LPC

Provider Business Mailing Address
First Line	:	311 CAMDEN ST STE 510
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78215-2015
Country	:	US
Telephone Number	:	210-591-1615
Fax Number	:	210-591-1635

Provider Business Practice Location Address
First Line	:	311 CAMDEN ST STE 510
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78215-2015
Country	:	US
Telephone Number	:	210-591-1615
Fax Number	:	210-591-1635

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

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	07/06/2016

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