Provider Demographics
NPI:1386934123
Name:IBARRA, RICARDO (LCSW-IPR)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:IBARRA
Suffix:
Gender:M
Credentials:LCSW-IPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29939 FM 2556
Mailing Address - Street 2:
Mailing Address - City:LA FERIA
Mailing Address - State:TX
Mailing Address - Zip Code:78559-6291
Mailing Address - Country:US
Mailing Address - Phone:956-536-2373
Mailing Address - Fax:956-854-4617
Practice Address - Street 1:29939 FM 2556
Practice Address - Street 2:
Practice Address - City:LA FERIA
Practice Address - State:TX
Practice Address - Zip Code:78559-6291
Practice Address - Country:US
Practice Address - Phone:956-536-7591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical