Basic Information
Provider Information
NPI: 1346720448
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PINKARD
FirstName: MARIA
MiddleName: LETICIA
NamePrefix: MRS.
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1326 HARBOR LIGHTS DR
Address2:  
City: CORPUS CHRISTI
State: TX
PostalCode: 784125337
CountryCode: US
TelephoneNumber: 3615638354
FaxNumber:  
Practice Location
Address1: 5524 BEE CAVES ROAD, SUITE K4
Address2:  
City: WEST LAKE HILLS
State: TX
PostalCode: 787467874
CountryCode: US
TelephoneNumber: 5127100551
FaxNumber: 5127176337
Other Information
ProviderEnumerationDate: 08/17/2018
LastUpdateDate: 06/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X70199TXN193400000X SINGLE SPECIALTY GROUPBehavioral Health & Social Service ProvidersCounselor 
101YM0800X70199TXY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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