Provider Demographics
NPI:1770350191
Name:ORTIZ, KRYSTAL II (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KRYSTAL
Middle Name:
Last Name:ORTIZ
Suffix:II
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 8183
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-9795
Mailing Address - Country:US
Mailing Address - Phone:787-553-0808
Mailing Address - Fax:
Practice Address - Street 1:CALLE ORQUIDEA A4
Practice Address - Street 2:URB. VERDUM II
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660-9795
Practice Address - Country:US
Practice Address - Phone:787-553-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR165751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical