Provider Demographics
NPI:1447623244
Name:LUGO-KINN, IRMA (LPC)
Entity type:Individual
Prefix:
First Name:IRMA
Middle Name:
Last Name:LUGO-KINN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MIMI
Other - Middle Name:E
Other - Last Name:LUGO-KINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1807 BOWEN AVE
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-4459
Mailing Address - Country:US
Mailing Address - Phone:512-553-1186
Mailing Address - Fax:
Practice Address - Street 1:14138 HWY 195
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-4850
Practice Address - Country:US
Practice Address - Phone:254-519-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YS0200X
TX74391101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101Y00000XBehavioral Health & Social Service ProvidersCounselor