Provider Demographics
NPI:1518180934
Name:NAVARRO, ANTONIO M (LCSW BCD)
Entity Type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:M
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:LCSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9480 HUEBNER RD STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1657
Mailing Address - Country:US
Mailing Address - Phone:210-614-9595
Mailing Address - Fax:210-615-7362
Practice Address - Street 1:9480 HUEBNER RD STE 210
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1657
Practice Address - Country:US
Practice Address - Phone:210-614-9595
Practice Address - Fax:210-615-7362
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100472303Medicaid