Provider Demographics
NPI:1114382942
Name:DASILVA, ROSANA (PHD, MS, LPC)
Entity type:Individual
Prefix:
First Name:ROSANA
Middle Name:
Last Name:DASILVA
Suffix:
Gender:
Credentials:PHD, MS, LPC
Other - Prefix:
Other - First Name:ROSANA
Other - Middle Name:
Other - Last Name:RIVERA-DELGADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ROSANA RIVERADELGADO
Mailing Address - Street 1:1560 E SOUTHLAKE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6462
Mailing Address - Country:US
Mailing Address - Phone:972-372-9839
Mailing Address - Fax:
Practice Address - Street 1:1560 E SOUTHLAKE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6462
Practice Address - Country:US
Practice Address - Phone:972-372-9839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
TX91969101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist