Provider Demographics
NPI:1811096498
Name:SANTIAGO, ALBERTO (CADAC, LADC)
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:CADAC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 WOODLAND STREET
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841
Mailing Address - Country:US
Mailing Address - Phone:978-687-0156
Mailing Address - Fax:
Practice Address - Street 1:60 ISLAND ST
Practice Address - Street 2:COUNSELING FOR CHANGE ASSOCIATES LLC.
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1835
Practice Address - Country:US
Practice Address - Phone:978-687-3700
Practice Address - Fax:425-928-2856
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1061101YA0400X
MA153C101YM0800X
MA1410101YP2500X
NH0555101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional