Provider Demographics
NPI:1396050654
Name:CANDELARIO, CAROL
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:CANDELARIO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:CABALLERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CAROL CABALLERO LLC
Mailing Address - Street 1:2968 MEADOW OAK DR S
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-3339
Mailing Address - Country:US
Mailing Address - Phone:201-208-4984
Mailing Address - Fax:
Practice Address - Street 1:2968 MEADOW OAK DR S
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3339
Practice Address - Country:US
Practice Address - Phone:201-208-4984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23242101YP2500X
NJ37PC00401200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional