Provider Demographics
NPI:1316090152
Name:FRAIRE, ESTHER LOPEZ (M ED, LPC)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:LOPEZ
Last Name:FRAIRE
Suffix:
Gender:F
Credentials:M ED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 N MCCOLL RD STE 15
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2464
Mailing Address - Country:US
Mailing Address - Phone:956-687-4668
Mailing Address - Fax:956-687-5770
Practice Address - Street 1:4425 N MCCOLL RD STE 15
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2464
Practice Address - Country:US
Practice Address - Phone:956-687-4668
Practice Address - Fax:956-687-5770
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17183101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145435702Medicaid