Priscilla Mia Caballero, LCDC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

204990 Issued in TX

Practice address

12130 Alamo Ranch Pkwy Apt 2612
San Antonio, TX 78253-4010

Phone

(210) 264-1940

NPI assigned

Feb 3, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Priscilla Mia Caballero Professional name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Camino Real Community MHMR CenterGroup PAC ID 9931183449, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Camino Real Community MHMR Center

  • Case Management Agency
  • Lytle, TX
  • NPI 1154411262
  Medicare reassignment Care Compare group NPD
• Camino Real Community MHMR Center

  • Case Management Agency
  • Lytle, TX
  • NPI 1033208327
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1104122423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12130 ALAMO RANCH PKWY APT 2612",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782534010",
            "telephone_number": "210-264-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12130 ALAMO RANCH PKWY APT 2612",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782534010",
            "telephone_number": "210-264-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABALLERO",
        "first_name": "PRISCILLA",
        "middle_name": "MIA",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-03",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "11117",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "95784",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "204990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRISCILLA",
            "last_name": "CABALLERO",
            "middle_name": "MIA",
            "credential": "LMFT, LCDC, LPC ASSO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jeannette Caballero, M.A.
• Karla Caballero, PSYD, LMFTS
• Kimberly Caballero
• Patricia Caballero, D.O.
• Patricia Ann Caballero, M.D.
• Rebecca Marie Caballero
• Arlene Caballes, RN BSN
• Cristia Cabanela, LVN
• Charlotte Ann Lind Cabaniss, SLP
• Adam Cabasos

• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.