Provider Demographics
NPI:1619127842
Name:SANTIAGO, ABNER (LPCMH)
Entity Type:Individual
Prefix:
First Name:ABNER
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N. HARRISON STREET
Mailing Address - Street 2:LATIN AMERICAN COMMUNITY CENTER
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805
Mailing Address - Country:US
Mailing Address - Phone:302-295-2160
Mailing Address - Fax:302-655-5798
Practice Address - Street 1:301 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3612
Practice Address - Country:US
Practice Address - Phone:302-295-2160
Practice Address - Fax:302-655-5798
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008423101YM0800X
DEPC-0000449101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health