Provider Demographics
NPI:1871702431
Name:CAVAZOS, ALONZO M JR (EDD, LCSW, LPC, CCH)
Entity type:Individual
Prefix:DR
First Name:ALONZO
Middle Name:M
Last Name:CAVAZOS
Suffix:JR
Gender:M
Credentials:EDD, LCSW, LPC, CCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 E FLYNN AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-4361
Mailing Address - Country:US
Mailing Address - Phone:956-454-5657
Mailing Address - Fax:
Practice Address - Street 1:1002 E FLYNN AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-4361
Practice Address - Country:US
Practice Address - Phone:956-454-5657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1995101YM0800X
TX037201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health