Provider Demographics
NPI:1366259913
Name:FAVELA, CECILIA (MED, LPC)
Entity type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:
Last Name:FAVELA
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6503 MEISTER ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6304
Mailing Address - Country:US
Mailing Address - Phone:806-206-3351
Mailing Address - Fax:
Practice Address - Street 1:6503 MEISTER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6304
Practice Address - Country:US
Practice Address - Phone:806-206-3351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90571101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional