Provider Demographics
NPI:1194037671
Name:BAERGA, IVETTE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:IVETTE
Middle Name:
Last Name:BAERGA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 CALLE PERLA
Mailing Address - Street 2:URBANIZACION ESTANCIAS
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-2092
Mailing Address - Country:US
Mailing Address - Phone:787-340-1815
Mailing Address - Fax:
Practice Address - Street 1:223 CALLE PERLA
Practice Address - Street 2:URBANIZACION ESTANCIAS
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757-2092
Practice Address - Country:US
Practice Address - Phone:787-340-1815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PR103991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)