| Maria T Isava, Lcsw | |
|
4425 Plano Pkwy Ste 701 Carrollton TX 75010-5031 | |
| (469) 469-9557 | |
| Not Available |
| Full Name | Maria T Isava, Lcsw |
|---|---|
| Speciality | Social Worker |
| Location | 4425 Plano Pkwy Ste 701, Carrollton, Texas |
| Authorized Official Name and Position | Adele Marie Konyk (OFFICE MANGER) |
| Authorized Official Contact | 5617028265 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maria T Isava, Lcsw 601 Shasta Ct Highland Village TX 75077-7056 Ph: (469) 469-9557 | Maria T Isava, Lcsw 4425 Plano Pkwy Ste 701 Carrollton TX 75010-5031 Ph: (469) 469-9557 |
| NPI Number | 1902447683 |
|---|---|
| Provider Enumeration Date | 10/03/2019 |
| Last Update Date | 10/28/2020 |
| Certification Date | 10/28/2020 |
| Medicare PECOS PAC ID | 5193139996 |
|---|---|
| Medicare Enrollment ID | O20210205000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902447683 | NPI | - | NPPES |
| 445232491 | Other | TX | BCBS TEXAS |
| 67389 | Other | TX | LICENSURE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Maria T Isava |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164769998 PECOS PAC ID: 8729215678 Enrollment ID: I20190708000476 |
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