Provider Demographics
NPI:1053883090
Name:GONZALEZ, EDUARDO T (LPC)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:T
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3222
Mailing Address - Country:US
Mailing Address - Phone:956-255-3132
Mailing Address - Fax:956-598-7355
Practice Address - Street 1:2027 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3222
Practice Address - Country:US
Practice Address - Phone:956-255-3132
Practice Address - Fax:956-598-7355
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-31
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77271101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX77271OtherTEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS