Provider Demographics
NPI:1922370592
Name:GONZALEZ, LILYBETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LILYBETH
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 PASEO AZUCENA
Mailing Address - Street 2:SEGUNDA SECCION DE LEVITTOWN
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4345
Mailing Address - Country:US
Mailing Address - Phone:787-269-5150
Mailing Address - Fax:787-269-5150
Practice Address - Street 1:PASEO AZUCENAS 2501
Practice Address - Street 2:SEGUNDA SECCION LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00949
Practice Address - Country:UM
Practice Address - Phone:787-269-5150
Practice Address - Fax:787-269-5150
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5463103TC0700X, 103TM1800X, 103TF0000X
103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service