Provider Demographics
NPI:1083406672
Name:MORALES BELEN, LUISA V
Entity type:Individual
Prefix:
First Name:LUISA
Middle Name:V
Last Name:MORALES BELEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PORTAL DEL PARQUE 61
Mailing Address - Street 2:CARR 848 APT 206
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3070
Mailing Address - Country:US
Mailing Address - Phone:787-408-0870
Mailing Address - Fax:
Practice Address - Street 1:1105 CALLE TRNIENTE CESAR GONZALEZ
Practice Address - Street 2:VILLA NEVAREZ
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-0000
Practice Address - Country:US
Practice Address - Phone:787-761-0715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR008207103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR008207OtherLICENCIA