Provider Demographics
NPI:1154627818
Name:GUIDANCE & COUNSELING ASSOCIATES OF LAREDO LLC
Entity Type:Organization
Organization Name:GUIDANCE & COUNSELING ASSOCIATES OF LAREDO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIA
Authorized Official - Middle Name:ELIZA
Authorized Official - Last Name:DAVILA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:956-284-0779
Mailing Address - Street 1:PO BOX 451315
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-0032
Mailing Address - Country:US
Mailing Address - Phone:956-284-0779
Mailing Address - Fax:
Practice Address - Street 1:6510 POLARIS DR
Practice Address - Street 2:STE 2 UNIT 10
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041
Practice Address - Country:US
Practice Address - Phone:956-284-0779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-28
Last Update Date:2011-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23884251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health