Provider Demographics
NPI:1215030382
Name:BARRIOS FELICIANO, NELSON (PSICOLOGO)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:
Last Name:BARRIOS FELICIANO
Suffix:
Gender:M
Credentials:PSICOLOGO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1879 CALLE FERMIN ZEDO
Mailing Address - Street 2:URB FAIR VIEW
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7627
Mailing Address - Country:US
Mailing Address - Phone:787-364-9688
Mailing Address - Fax:939-697-6003
Practice Address - Street 1:23-7 AVE ROBERTO CLEMENTE
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5413
Practice Address - Country:US
Practice Address - Phone:787-364-9688
Practice Address - Fax:939-697-6003
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1846103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR219012OtherPREFERRED HEALTH
PR075181OtherCRUZ AZUL
PR2034OtherHUMANA
PR2249319OtherCIGNA BEHAVIOR
PR2356OtherAPS HEALTH CARE
PR2357OtherMEDICARE MUCHO MAS
PR9766OtherINT MEDICARD CARD
PR9766OtherINT MEDICARD CARD