Provider Demographics
NPI:1033791389
Name:ESCOBAR-PAGAN, JENNIFER STEPHANIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:STEPHANIE
Last Name:ESCOBAR-PAGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 SAGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-7711
Mailing Address - Country:US
Mailing Address - Phone:909-714-5373
Mailing Address - Fax:
Practice Address - Street 1:201 E 9TH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-2229
Practice Address - Country:US
Practice Address - Phone:972-502-4012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX653201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical