Provider Demographics
NPI:1467559930
Name:CONTRERAS-RIOS, YOLANDA (LCSW)
Entity type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:
Last Name:CONTRERAS-RIOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7117 BLACK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7260
Mailing Address - Country:US
Mailing Address - Phone:915-820-9459
Mailing Address - Fax:
Practice Address - Street 1:2927 PERSHING DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-2419
Practice Address - Country:US
Practice Address - Phone:915-820-9459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX256081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1625154-01Medicaid