Provider Demographics
NPI:1073107934
Name:BERRIOS, ELISA TERESA (LCSW)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:TERESA
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB TURABO GARDENS 2
Mailing Address - Street 2:T10 CALLE 28
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:939-350-9475
Mailing Address - Fax:
Practice Address - Street 1:URB TURABO GARDENS 2
Practice Address - Street 2:T10 CALLE 28
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-0072
Practice Address - Country:US
Practice Address - Phone:939-350-9475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR127831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical