Provider Demographics
NPI:1194333633
Name:TREVINO, LAUREN ALYSSA (LPC-I, LMFT-A)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ALYSSA
Last Name:TREVINO
Suffix:
Gender:F
Credentials:LPC-I, LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 WILCREST DR STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-2754
Mailing Address - Country:US
Mailing Address - Phone:832-789-3725
Mailing Address - Fax:832-777-3218
Practice Address - Street 1:2500 WILCREST DR STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-2754
Practice Address - Country:US
Practice Address - Phone:832-789-3725
Practice Address - Fax:832-777-3218
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83580101YP2500X
TX203660106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty