Provider Demographics
NPI:1053897926
Name:BARRIENTOS, LAURA (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BARRIENTOS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 GARDENIA CIR
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-2187
Mailing Address - Country:US
Mailing Address - Phone:956-437-5831
Mailing Address - Fax:
Practice Address - Street 1:7210 W INTERSTATE 2 STE B
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-9526
Practice Address - Country:US
Practice Address - Phone:956-897-5160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76769101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty