Provider Demographics
NPI:1770894727
Name:GAVIRIA-MUNOZ, DAVID ANDRES (LPC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANDRES
Last Name:GAVIRIA-MUNOZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8103 CARROLL AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-7347
Mailing Address - Country:US
Mailing Address - Phone:703-220-4206
Mailing Address - Fax:202-723-4560
Practice Address - Street 1:1400 DECATUR ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4343
Practice Address - Country:US
Practice Address - Phone:202-291-4707
Practice Address - Fax:202-723-4560
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCADD13984101YA0400X
DCPRC13970101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)