Provider Demographics
NPI:1770826315
Name:SERRANO, JOSE MANUEL (LPC)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MANUEL
Last Name:SERRANO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CALLE GUAYANILLA
Mailing Address - Street 2:COND TOWN HOUSE APT 707
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923-3312
Mailing Address - Country:US
Mailing Address - Phone:787-368-8530
Mailing Address - Fax:
Practice Address - Street 1:500 CALLE GUAYANILLA
Practice Address - Street 2:COND TOWN HOUSE APT 707
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-3312
Practice Address - Country:US
Practice Address - Phone:787-368-8530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0289101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional