Basic Information
| Provider Information | |||||||||
| NPI: | 1972117679 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CABALLERO | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | LISW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 KALISA WAY STE 101 | ||||||||
| Address2: | |||||||||
| City: | PARAMUS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076523508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889486789 | ||||||||
| FaxNumber: | 8773453501 | ||||||||
| Practice Location | |||||||||
| Address1: | 3456 INDIAN CREEK RD | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | IA | ||||||||
| PostalCode: | 523021119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3194303451 | ||||||||
| FaxNumber: | 8773453501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2020 | ||||||||
| LastUpdateDate: | 07/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 05977 | IA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.