Provider Demographics
NPI:1245680172
Name:SANTIAGO, NADJA MARIE (LPC)
Entity type:Individual
Prefix:MS
First Name:NADJA
Middle Name:MARIE
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 COND TORRE DE CAPARRA
Mailing Address - Street 2:CARR 2 APTO 3D
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-410-7255
Mailing Address - Fax:
Practice Address - Street 1:244 COND TORRE DE CAPARRA
Practice Address - Street 2:CARR 2 APTO 3D
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-410-7255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004161101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health