Provider Demographics
NPI:1699288464
Name:GONZALEZ-LEWIS, EVA (LMSW)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:GONZALEZ-LEWIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:1511 E YANDELL DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5629
Mailing Address - Country:US
Mailing Address - Phone:915-239-2955
Mailing Address - Fax:915-249-6155
Practice Address - Street 1:1225 E. CLIFF DR BLDG 3 STE#100
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902
Practice Address - Country:US
Practice Address - Phone:915-239-2955
Practice Address - Fax:915-249-6155
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65130104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker