Provider Demographics
NPI:1154645455
Name:GONZALEZ LEBRON, LILIBETH
Entity Type:Individual
Prefix:MISS
First Name:LILIBETH
Middle Name:
Last Name:GONZALEZ LEBRON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:GONZALEZ
Other - Middle Name:LEBRON
Other - Last Name:LILIBETH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:HC 63 BOX 3331
Mailing Address - Street 2:SECTOR CONEJO BLANCO
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-9608
Mailing Address - Country:US
Mailing Address - Phone:787-686-0170
Mailing Address - Fax:787-686-0173
Practice Address - Street 1:COND CARIBE
Practice Address - Street 2:CALLE ALDA 1549
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-2400
Practice Address - Country:US
Practice Address - Phone:787-686-0170
Practice Address - Fax:787-686-0173
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR97891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical