1952655227 NPI number — MRS. AMERICA MENCOS CABALLERO LPC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952655227 NPI number — MRS. AMERICA MENCOS CABALLERO LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CABALLERO
Provider First Name:
AMERICA
Provider Middle Name:
MENCOS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MENCOS GALIANO
Provider Other First Name:
ZOILA
Provider Other Middle Name:
AMERICA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1952655227
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16220 FREDERICK RD,
Provider Second Line Business Mailing Address:
SUITE 502
Provider Business Mailing Address City Name:
GAITHERSBURG
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20877
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-978-9750
Provider Business Mailing Address Fax Number:
301-978-9753

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19375 GERMANTOWN ROAD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
GERMANTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20874
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-634-9600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  LC4719 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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