Provider Demographics
NPI:1124445507
Name:ESCOBAR, CARLO ARIS (LCSW)
Entity type:Individual
Prefix:MR
First Name:CARLO
Middle Name:ARIS
Last Name:ESCOBAR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 E TYLER AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7116
Mailing Address - Country:US
Mailing Address - Phone:956-421-2153
Mailing Address - Fax:
Practice Address - Street 1:1706 E TYLER AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7116
Practice Address - Country:US
Practice Address - Phone:956-421-2153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX541161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical