Provider Demographics
NPI:1588210595
Name:FERRER, LUIS A (LCDO)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:A
Last Name:FERRER
Suffix:
Gender:M
Credentials:LCDO
Other - Prefix:PROF
Other - First Name:LUIS
Other - Middle Name:A
Other - Last Name:FERRER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MCSW
Mailing Address - Street 1:RR 2 BOX 2963
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-9401
Mailing Address - Country:US
Mailing Address - Phone:787-447-1210
Mailing Address - Fax:
Practice Address - Street 1:CARR 402 KM 4.0
Practice Address - Street 2:BO CARACOL
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-447-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR96431041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool