Provider Demographics
NPI:1710772942
Name:GAYTAN, MAGDA ELIA (LPC)
Entity type:Individual
Prefix:MRS
First Name:MAGDA
Middle Name:ELIA
Last Name:GAYTAN
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 FM 775
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-8511
Mailing Address - Country:US
Mailing Address - Phone:830-534-2429
Mailing Address - Fax:
Practice Address - Street 1:1600 FM 775
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-8511
Practice Address - Country:US
Practice Address - Phone:830-534-2429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92615101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional