Provider Demographics
NPI:1053090704
Name:ARCINIEGA, SUSAN (LCSW, LMFT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:ARCINIEGA
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8226 PARKLAND HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-5688
Mailing Address - Country:US
Mailing Address - Phone:210-363-7294
Mailing Address - Fax:
Practice Address - Street 1:6502 BANDERA RD # 212
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1400
Practice Address - Country:US
Practice Address - Phone:210-363-7294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4151106H00000X
TX170411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist