Provider Demographics
NPI:1689128464
Name:CLINICA DE SERVICIOS PSICOLOGICOS DRA MORALES CASANAS, CSP
Entity Type:Organization
Organization Name:CLINICA DE SERVICIOS PSICOLOGICOS DRA MORALES CASANAS, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIRETZY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-545-2400
Mailing Address - Street 1:G2514 PASEO AMPARO
Mailing Address - Street 2:LEVITTOWN LAKES
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-545-2400
Mailing Address - Fax:787-545-2400
Practice Address - Street 1:G2514 PASEO AMPARO
Practice Address - Street 2:LEVITTOWN LAKES
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-545-2400
Practice Address - Fax:787-545-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2878103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty