MEDICARE: CLAUDIA RAQUEL DAVILA LPC, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	81079	TX
2	1041C0700X	Clinical Social Worker	50813	TX

General Provider Information

NPI Number	:	1528243946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA RAQUEL DAVILA LPC, LCSW

Provider Business Mailing Address
First Line	:	5899 PRESTON RD STE 1102
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-9594
Country	:	US
Telephone Number	:	469-573-4354
Fax Number	:

Provider Business Practice Location Address
First Line	:	5899 PRESTON RD STE 1102
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-9594
Country	:	US
Telephone Number	:	469-573-4354
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	08/07/2022

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