Provider Demographics
NPI:1073999348
Name:CABALLERO, EDITH C (LCSW)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:C
Last Name:CABALLERO
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 1:2121 BISCAYNE BLVD
Mailing Address - Street 2:#1321
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137
Mailing Address - Country:US
Mailing Address - Phone:305-349-3154
Mailing Address - Fax:
Practice Address - Street 1:2121 BISCAYNE BLVD
Practice Address - Street 2:#1321
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137
Practice Address - Country:US
Practice Address - Phone:305-349-3154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 130371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical