Provider Demographics
NPI:1053037655
Name:ESPARZA, MARILENA JEAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARILENA
Middle Name:JEAN
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MARILENA
Other - Middle Name:JEAN
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:32393 HACKBERRY RD
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-7330
Mailing Address - Country:US
Mailing Address - Phone:956-241-8163
Mailing Address - Fax:
Practice Address - Street 1:32393 HACKBERRY RD
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-7330
Practice Address - Country:US
Practice Address - Phone:956-241-8163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX570501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty