Provider Demographics
NPI:1164769998
Name:ISAVA, MARIA T (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:T
Last Name:ISAVA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:T
Other - Last Name:ISAVA, LCSW PLLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:601 SHASTA CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7056
Mailing Address - Country:US
Mailing Address - Phone:469-469-9557
Mailing Address - Fax:
Practice Address - Street 1:4425 PLANO PKWY STE 701
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-5031
Practice Address - Country:US
Practice Address - Phone:469-469-9557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX673891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical