Provider Demographics
NPI:1306345517
Name:ESCARCEGA, LYDIA (LPC)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:ESCARCEGA
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 1:280 COUNTY ROAD 338
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:TX
Mailing Address - Zip Code:76530-5692
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:280 COUNTY ROAD 338
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:TX
Practice Address - Zip Code:76530-5692
Practice Address - Country:US
Practice Address - Phone:512-563-9070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-03
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YS0200X
TX74723101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional