Provider Demographics
NPI:1346530508
Name:MORALES, LAURA (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MORALES
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 1:706 BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78374-4100
Mailing Address - Country:US
Mailing Address - Phone:361-442-5072
Mailing Address - Fax:
Practice Address - Street 1:5449 BEAR LN STE 414
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-4124
Practice Address - Country:US
Practice Address - Phone:361-888-8834
Practice Address - Fax:361-888-8837
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61071101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138708611Medicaid
TX138708613Medicaid
TX138708610Medicaid