Provider Demographics
NPI:1780603340
Name:DAVIS, DELANA RONDRICI (LCSW)
Entity type:Individual
Prefix:
First Name:DELANA
Middle Name:RONDRICI
Last Name:DAVIS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WOODS OF BOERNE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2882
Mailing Address - Country:US
Mailing Address - Phone:830-967-7422
Mailing Address - Fax:
Practice Address - Street 1:101 WOODS OF BOERNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2882
Practice Address - Country:US
Practice Address - Phone:830-967-7422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX338951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
8B9596Medicare ID - Type Unspecified
741153067-78229-A037Medicare UPIN