Provider Demographics
NPI:1922878537
Name:HERNANDEZ, MARIELYS ALEXANDRA (LPC)
Entity type:Individual
Prefix:
First Name:MARIELYS
Middle Name:ALEXANDRA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 CALLE JUAN BORIA
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-5000
Mailing Address - Country:US
Mailing Address - Phone:939-625-0292
Mailing Address - Fax:
Practice Address - Street 1:63 AVE LUIS MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-898-2660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4769101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)