MEDICARE: CANDELARIA HARRIS 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	92052	TX

General Provider Information

NPI Number	:	1649869058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDELARIA HARRIS LPC

Provider Business Mailing Address
First Line	:	201 E MAIN DR STE 600
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79901-1385
Country	:	US
Telephone Number	:	915-887-3410
Fax Number	:	915-351-3643

Provider Business Practice Location Address
First Line	:	10737 GATEWAY BLVD W STE 250
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79935-4912
Country	:	US
Telephone Number	:	915-242-0555
Fax Number	:	915-351-4707

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

Provider Enumeration Date	:	01/12/2021
Last Update Date	:	07/22/2025

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Directions to “ CANDELARIA HARRIS LPC” Practice Location

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