Provider Demographics
NPI:1659473288
Name:DAVILA, ELIA ELIZA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIA
Middle Name:ELIZA
Last Name:DAVILA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8813 WYNDOM TERRACE TRL
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-8610
Mailing Address - Country:US
Mailing Address - Phone:956-286-6274
Mailing Address - Fax:877-684-1615
Practice Address - Street 1:6551 STAR CT
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-9140
Practice Address - Country:US
Practice Address - Phone:956-523-7850
Practice Address - Fax:956-523-7851
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2011-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX238841041C0700X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical