MEDICARE: CECI BURGOS COUNSELING, INC.

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	101YM0800X	Mental Health Counselor	15330	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	:	1588876213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CECI BURGOS COUNSELING, INC.

Provider Business Mailing Address
First Line	:	468 SAN BLAS DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4319
Country	:	US
Telephone Number	:	915-525-9246
Fax Number	:

Provider Business Practice Location Address
First Line	:	468 SAN BLAS DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4319
Country	:	US
Telephone Number	:	915-525-9246
Fax Number	:

Authorized Official
Title or Position	:	PROPRIETOR
Name	:	CECILIA BURGOS
Credential	:	LPC
Telephone Number	:	915-525-9246

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	06/12/2024

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