Provider Demographics
NPI:1134561376
Name:CAVAZOS, ELAINE H (MSW)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:H
Last Name:CAVAZOS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4022 MENCHACA RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6746
Mailing Address - Country:US
Mailing Address - Phone:512-982-4116
Mailing Address - Fax:
Practice Address - Street 1:4022 MENCHACA RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6746
Practice Address - Country:US
Practice Address - Phone:512-982-4116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical