Provider Demographics
NPI:1780151050
Name:DAVILA, DANIEL II (LPC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:DAVILA
Suffix:II
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 1:8002 OSPREY ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2742
Mailing Address - Country:US
Mailing Address - Phone:361-548-7063
Mailing Address - Fax:
Practice Address - Street 1:1630 S BROWNLEE BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3134
Practice Address - Country:US
Practice Address - Phone:361-886-1065
Practice Address - Fax:361-886-6917
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67773101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health