Provider Demographics
NPI:1366240780
Name:VELAZQUEZ-SOTO, LUIS RAUL (LPCACART, LCDC, CSAT)
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:RAUL
Last Name:VELAZQUEZ-SOTO
Suffix:
Gender:M
Credentials:LPCACART, LCDC, CSAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 ELM CROSSING TRL
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1394
Mailing Address - Country:US
Mailing Address - Phone:346-305-0374
Mailing Address - Fax:
Practice Address - Street 1:1544 SAWDUST RD STE 260
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2986
Practice Address - Country:US
Practice Address - Phone:832-303-8933
Practice Address - Fax:832-383-3817
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16808101YA0400X
TX96784101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health