Provider Demographics
NPI:1992353528
Name:REYES, EDIBERTO JR (LPC)
Entity type:Individual
Prefix:MR
First Name:EDIBERTO
Middle Name:
Last Name:REYES
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 N 16TH ST STE 124
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-7984
Mailing Address - Country:US
Mailing Address - Phone:956-778-8747
Mailing Address - Fax:
Practice Address - Street 1:3118 CENTER POINT DR STE 3
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-687-8000
Practice Address - Fax:956-687-8009
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78990101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional