Provider Demographics
NPI:1699090951
Name:SERNA, NICOL RENE' (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:NICOL
Middle Name:RENE'
Last Name:SERNA
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 AMBER FOREST TRL
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1384
Mailing Address - Country:US
Mailing Address - Phone:254-654-0043
Mailing Address - Fax:
Practice Address - Street 1:1004 PIN OAK DR
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1023
Practice Address - Country:US
Practice Address - Phone:254-654-0043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional