Provider Demographics
NPI:1750582532
Name:MORALES, JESUS (MSW, CAC)
Entity type:Individual
Prefix:MR
First Name:JESUS
Middle Name:
Last Name:MORALES
Suffix:
Gender:M
Credentials:MSW, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 CALLE PUERTA DEL CIELO
Mailing Address - Street 2:EL PEDREGAL 16
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3723
Mailing Address - Country:US
Mailing Address - Phone:787-366-5336
Mailing Address - Fax:
Practice Address - Street 1:80 CALLE PUERTA DEL CIELO
Practice Address - Street 2:EL PEDREGAL 16
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3723
Practice Address - Country:US
Practice Address - Phone:787-366-5336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2394101YM0800X, 1041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool