Provider Demographics
NPI:1841335247
Name:SOLORZANO, BERNADETTE (LPC)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:SOLORZANO
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 1:324 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-4352
Mailing Address - Country:US
Mailing Address - Phone:210-434-1054
Mailing Address - Fax:210-434-1380
Practice Address - Street 1:590 N GENERAL MCMULLEN DR
Practice Address - Street 2:SUITE NUMBER 3
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-6205
Practice Address - Country:US
Practice Address - Phone:210-434-1054
Practice Address - Fax:210-434-1380
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16408103T00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159118202Medicaid