Provider Demographics
NPI:1134987092
Name:CASCOS, HAVANNAH MARCELA (LPC)
Entity type:Individual
Prefix:
First Name:HAVANNAH
Middle Name:MARCELA
Last Name:CASCOS
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 1:5205 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3818
Mailing Address - Country:US
Mailing Address - Phone:956-521-8217
Mailing Address - Fax:
Practice Address - Street 1:413 E RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:PORT ISABEL
Practice Address - State:TX
Practice Address - Zip Code:78578-4133
Practice Address - Country:US
Practice Address - Phone:956-451-8113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional