Provider Demographics
NPI:1437263191
Name:DILSAVER, ERICA RENEE (LPC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:RENEE
Last Name:DILSAVER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W STRICKLAND ST
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-5730
Mailing Address - Country:US
Mailing Address - Phone:210-725-5942
Mailing Address - Fax:
Practice Address - Street 1:210 W STRICKLAND ST
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-5730
Practice Address - Country:US
Practice Address - Phone:210-725-5942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TX15439101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1131310-05Medicaid
TX113131007Medicaid