Provider Demographics
NPI:1679604359
Name:CARAVEO, KATHY M (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:M
Last Name:CARAVEO
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 N MESA ST
Mailing Address - Street 2:238
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3613
Mailing Address - Country:US
Mailing Address - Phone:915-356-4703
Mailing Address - Fax:
Practice Address - Street 1:7101 N MESA ST
Practice Address - Street 2:238
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3613
Practice Address - Country:US
Practice Address - Phone:915-356-4703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15295101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121975005Medicaid