Provider Demographics
NPI:1487984530
Name:CRIADO, LESLIE (PSYD, MSW)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:
Last Name:CRIADO
Suffix:
Gender:F
Credentials:PSYD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3326 AVE BOULEVARD
Mailing Address - Street 2:3RA SECC LEVITTOWN
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:939-275-3335
Mailing Address - Fax:787-261-9090
Practice Address - Street 1:CHARDON AVE ANGEL RAMOS FOUNDATION 2
Practice Address - Street 2:APS HEALTHCARE PR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-641-0773
Practice Address - Fax:787-641-0776
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
PR6038103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical