Provider Demographics
NPI:1417569492
Name:BERRIOS DEL VALLE, NATHALIA SOFIA (MSW)
Entity Type:Individual
Prefix:
First Name:NATHALIA
Middle Name:SOFIA
Last Name:BERRIOS DEL VALLE
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:URB. FERNANDEZ CALLE KENNEDY #16 CIDRA, PR 00739
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739
Mailing Address - Country:US
Mailing Address - Phone:787-205-3378
Mailing Address - Fax:
Practice Address - Street 1:URB. FERNANDEZ CALLE KENNEDY #16 CIDRA, PR 00739
Practice Address - Street 2:
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-205-3378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR149681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR14968OtherSTATE DEPARTMENT OF PUERTO RICO / SOCIAL WORKER LICENSE