Provider Demographics
NPI:1427300011
Name:YESENIA Y RIOS
Entity type:Organization
Organization Name:YESENIA Y RIOS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:956-537-3989
Mailing Address - Street 1:509 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-4659
Mailing Address - Country:US
Mailing Address - Phone:956-537-3989
Mailing Address - Fax:
Practice Address - Street 1:509 S CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4659
Practice Address - Country:US
Practice Address - Phone:956-537-3989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20313101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179706004Medicaid