Provider Demographics
NPI:1538660790
Name:SANTIAGO, CHAILYS (MSW)
Entity Type:Individual
Prefix:
First Name:CHAILYS
Middle Name:
Last Name:SANTIAGO
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:PO BOX 801504
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1504
Mailing Address - Country:US
Mailing Address - Phone:787-202-0014
Mailing Address - Fax:
Practice Address - Street 1:344 CALLE NOVICIA
Practice Address - Street 2:URB LAS MONJITAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730
Practice Address - Country:US
Practice Address - Phone:787-202-0014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR113641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical