Provider Demographics
NPI:1306611009
Name:ESCOBEDO, YAJAIRA (LMSW LCDC)
Entity type:Individual
Prefix:MRS
First Name:YAJAIRA
Middle Name:
Last Name:ESCOBEDO
Suffix:
Gender:F
Credentials:LMSW LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 N IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-5558
Mailing Address - Country:US
Mailing Address - Phone:956-545-3493
Mailing Address - Fax:
Practice Address - Street 1:590 N IOWA AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-5558
Practice Address - Country:US
Practice Address - Phone:956-545-3493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX656391041S0200X
TX15421101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)