Provider Demographics
NPI:1417370867
Name:CABALLERO-MCMECHEN, JACQUELINE B (LCSW)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:B
Last Name:CABALLERO-MCMECHEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:B
Other - Last Name:CABALLERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 BOYDEN AVENUE
Mailing Address - Street 2:#379
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040
Mailing Address - Country:US
Mailing Address - Phone:347-915-5414
Mailing Address - Fax:
Practice Address - Street 1:200 BOYDEN AVENUE
Practice Address - Street 2:#379
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040
Practice Address - Country:US
Practice Address - Phone:347-915-5414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0616221041C0700X
NYPR-0616221041C0700X
NJ44SC055557001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical