Provider Demographics
NPI:1366109944
Name:HINOJOSA, CRYSTAL (MA, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:HINOJOSA
Suffix:
Gender:F
Credentials:MA, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 BRODIE LN STE 160
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5892
Mailing Address - Country:US
Mailing Address - Phone:956-533-8821
Mailing Address - Fax:
Practice Address - Street 1:1825 FORT VIEW RD
Practice Address - Street 2:SUITE 112G
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704
Practice Address - Country:US
Practice Address - Phone:956-533-8821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84903101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional