Provider Demographics
NPI:1972124824
Name:ESCOBAR, MARINA ELIA (LPC)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:ELIA
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3118 CENTER POINT DR STE 3
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-4804
Mailing Address - Country:US
Mailing Address - Phone:956-687-8000
Mailing Address - Fax:956-687-8009
Practice Address - Street 1:801 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-2276
Practice Address - Country:US
Practice Address - Phone:956-787-0787
Practice Address - Fax:956-787-2021
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79843101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional