1821002395 NPI number — KAREN JOANNE CABRAL LPC LMFT

Table of content: KAREN JOANNE CABRAL LPC LMFT (NPI 1821002395)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821002395 NPI number — KAREN JOANNE CABRAL LPC LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CABRAL
Provider First Name:
KAREN
Provider Middle Name:
JOANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821002395
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5825 CALLAGHAN RD
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78228-1124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-521-4833
Provider Business Mailing Address Fax Number:
210-521-8561

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5825 CALLAGHAN RD
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78228-1124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-521-4833
Provider Business Practice Location Address Fax Number:
210-521-8561
Provider Enumeration Date:
07/28/2006

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:  LPC11500 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106H00000X , with the licence number: LMFT003206 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0954844 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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