Provider Demographics
NPI:1285917013
Name:SERRANO, SARA MARIE (LPC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:SERRANO
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 VILLAGE DR STE A
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-4157
Mailing Address - Country:US
Mailing Address - Phone:361-570-1444
Mailing Address - Fax:361-570-1446
Practice Address - Street 1:1402 VILLAGE DR STE A
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-4157
Practice Address - Country:US
Practice Address - Phone:361-570-1444
Practice Address - Fax:361-570-1446
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65815101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX283654602Medicaid
TX65815OtherLPC LICENSE