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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

JOSE I CARBAJAL, PHD, LCSW
412 NORTH ST
SUITE B
NACOGDOCHES, TX75961-5077
 Phone: 936-622-0993
 Fax: 936-622-0994
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for JOSE I CARBAJAL · (Male)

NPI Number 1609041862
Credentials PHD, LCSW
Entity Individual
Enumeration date 04/28/2008
Last updated 04/06/2015 - More than a year ago
Sole proprietor 1 Yes
Identifiers
TX License # 40907
TX Medicaid 194247601
Hospital affiliation(s) n/a
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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