Provider Demographics
NPI:1679202261
Name:CARABALLO TORRES, NASHALY (LCSW)
Entity Type:Individual
Prefix:
First Name:NASHALY
Middle Name:
Last Name:CARABALLO TORRES
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:P.O. BOX 5004 PMB 130
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-5004
Mailing Address - Country:US
Mailing Address - Phone:787-964-1190
Mailing Address - Fax:
Practice Address - Street 1:23 CALLE MATIENZO CINTRON # LOCAL1
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3915
Practice Address - Country:US
Practice Address - Phone:787-964-1190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty