Provider Demographics
NPI:1518918911
Name:MAGALLANES, BARBARA D (LCSW, CHT, CEAP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:D
Last Name:MAGALLANES
Suffix:
Gender:F
Credentials:LCSW, CHT, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7309
Mailing Address - Country:US
Mailing Address - Phone:956-466-8517
Mailing Address - Fax:
Practice Address - Street 1:1713 BOCA CHICA BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8140
Practice Address - Country:US
Practice Address - Phone:956-459-6372
Practice Address - Fax:956-284-0143
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS15558101YM0800X
TX155581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX071317402Medicaid