Provider Demographics
NPI:1619201092
Name:CABALLERO, FELIX ESEQUIEL (LMHC)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:ESEQUIEL
Last Name:CABALLERO
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4737
Mailing Address - Country:US
Mailing Address - Phone:701-746-0405
Mailing Address - Fax:701-746-5918
Practice Address - Street 1:211 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4737
Practice Address - Country:US
Practice Address - Phone:701-746-0405
Practice Address - Fax:701-746-5918
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM71750274Medicaid