Provider Demographics
NPI:1568918035
Name:SANCHEZ CASO, LUIS M (PSY D)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:M
Last Name:SANCHEZ CASO
Suffix:
Gender:M
Credentials:PSY D
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 360275
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-0275
Mailing Address - Country:US
Mailing Address - Phone:787-783-0123
Mailing Address - Fax:
Practice Address - Street 1:356 CALLE ENSENADA
Practice Address - Street 2:STE E FL 2
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-3501
Practice Address - Country:US
Practice Address - Phone:787-783-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TA0700X, 103TC2200X, 103TM1800X
PR1154103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities