Provider Demographics
NPI:1992458483
Name:HILLENBRAND, TERESA R (LPC, LCDCI)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:R
Last Name:HILLENBRAND
Suffix:
Gender:F
Credentials:LPC, LCDCI
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:ROSA
Other - Last Name:RUIZ-VELASCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA, MS
Mailing Address - Street 1:4835 MEDICAL DR UNIT 40141
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-8040
Mailing Address - Country:US
Mailing Address - Phone:210-920-0488
Mailing Address - Fax:726-204-6080
Practice Address - Street 1:4014 MIDVALE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-920-0488
Practice Address - Fax:726-204-6080
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83811101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional