Provider Demographics
NPI:1710131495
Name:CABALLERO, MARLENE (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 E MILE 13 N
Mailing Address - Street 2:
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-7195
Mailing Address - Country:US
Mailing Address - Phone:956-463-1574
Mailing Address - Fax:956-464-7425
Practice Address - Street 1:536 S TEXAS BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6264
Practice Address - Country:US
Practice Address - Phone:956-463-1574
Practice Address - Fax:956-464-7425
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61588101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197872802Medicaid