Provider Demographics
NPI:1932939394
Name:SALDIVAR, MICHELLE INETTE (LPC, LSSP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:INETTE
Last Name:SALDIVAR
Suffix:
Gender:F
Credentials:LPC, LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 MIZELL ST
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-3416
Mailing Address - Country:US
Mailing Address - Phone:972-748-6719
Mailing Address - Fax:
Practice Address - Street 1:218 MIZELL ST
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3416
Practice Address - Country:US
Practice Address - Phone:972-748-6719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88908101YP2500X, 101YM0800X
TX33141103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool