Provider Demographics
NPI:1124613070
Name:PENA, AARON OMAR (LPC)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:OMAR
Last Name:PENA
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 1:423 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2915
Mailing Address - Country:US
Mailing Address - Phone:956-600-7133
Mailing Address - Fax:956-600-7101
Practice Address - Street 1:423 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2915
Practice Address - Country:US
Practice Address - Phone:956-600-7133
Practice Address - Fax:956-600-7101
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional