Provider Demographics
NPI:1326311648
Name:BERRIOS, KARLA MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:MARIE
Last Name:BERRIOS
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 1:609 AVE TITO CASTRO
Mailing Address - Street 2:SUITE 102 PBM 380
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-0200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:609 AVE TITO CASTRO
Practice Address - Street 2:SUITE 102 PBM 380
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-0200
Practice Address - Country:US
Practice Address - Phone:787-292-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR109021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical