Provider Demographics
NPI:1154789626
Name:AVITIA, ELVIA D (LPC-S)
Entity type:Individual
Prefix:
First Name:ELVIA
Middle Name:D
Last Name:AVITIA
Suffix:
Gender:
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E MCINTYRE ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-3620
Mailing Address - Country:US
Mailing Address - Phone:956-289-9348
Mailing Address - Fax:
Practice Address - Street 1:600 E MCINTYRE ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-3620
Practice Address - Country:US
Practice Address - Phone:956-289-9348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-29
Last Update Date:2025-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TX72449101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health