Healthcare Provider Details

I. General information

NPI: 1992241905
Provider Name (Legal Business Name): BEATRIZ ZAVALA MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2017
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 SURETY DR
EL PASO TX
79905-2043
US

IV. Provider business mailing address

PO BOX 640318
EL PASO TX
79904-0318
US

V. Phone/Fax

Practice location:
  • Phone: 785-787-3077
  • Fax:
Mailing address:
  • Phone: 915-502-0879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number63178
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: