Provider Demographics
NPI:1427570936
Name:PRECIADO, SOCORRO (LPC)
Entity type:Individual
Prefix:MS
First Name:SOCORRO
Middle Name:
Last Name:PRECIADO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 N BUCKNER BLVD STE 504
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-4861
Mailing Address - Country:US
Mailing Address - Phone:972-502-4140
Mailing Address - Fax:214-553-8028
Practice Address - Street 1:7502 FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5404
Practice Address - Country:US
Practice Address - Phone:972-502-4140
Practice Address - Fax:214-553-8028
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67512101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional