Provider Demographics
NPI:1104486687
Name:ARELLANO, ANABENITA (LPC)
Entity type:Individual
Prefix:
First Name:ANABENITA
Middle Name:
Last Name:ARELLANO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:
Other - Last Name:ARELLANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3571 FAR WEST BLVD # 78
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3064
Mailing Address - Country:US
Mailing Address - Phone:210-414-5813
Mailing Address - Fax:
Practice Address - Street 1:12507 RAMPART ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-4454
Practice Address - Country:US
Practice Address - Phone:512-953-3410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77515101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health