Provider Demographics
NPI:1316296262
Name:EATON, DAVID S (LPC, LMHC, CCMHC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:EATON
Suffix:
Gender:M
Credentials:LPC, LMHC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 MISSION VIEJO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2779
Mailing Address - Country:US
Mailing Address - Phone:910-574-1066
Mailing Address - Fax:
Practice Address - Street 1:6333 DEZAVALA RD
Practice Address - Street 2:SUITE B101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249
Practice Address - Country:US
Practice Address - Phone:210-399-4838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004166101YM0800X
TX80764101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health