Individual provider · NPI-1

Carlos Ivan Acosta, Masters

Counselor, Professional · Addison, TX

NPI number1124869268
StatusActive
Last updated in NPPESJun 3, 2024

Details

NPI
1124869268
Entity type
Individual (NPI-1)
Name
Carlos Ivan Acosta
Credential
Masters
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 3, 2024
Certification date
Jun 3, 2024
Last updated
Jun 3, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional94959TXYes

Practice location

15851 Dallas Pkwy
Addison, TX 75001-3369

Phone 214-267-9556 · Fax 833-457-1700

Mailing address

3001 Lisa Ln
Arlington, TX 76013-2039

Phone 817-881-9804

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