Provider Demographics
NPI:1477200889
Name:ESQUIVEL, ISAAC (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:
Last Name:ESQUIVEL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-0508
Mailing Address - Country:US
Mailing Address - Phone:469-264-1616
Mailing Address - Fax:
Practice Address - Street 1:245 WEST HIGHWAY 114, SUITE 200
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092
Practice Address - Country:US
Practice Address - Phone:877-504-8904
Practice Address - Fax:855-420-6402
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-05
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1477200889OtherNPI