Provider Demographics
NPI:1548503113
Name:PARDO, MARIA CARMEN (MSW)
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:CARMEN
Last Name:PARDO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1062
Mailing Address - Street 2:
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-1062
Mailing Address - Country:US
Mailing Address - Phone:787-612-4947
Mailing Address - Fax:
Practice Address - Street 1:47 CALLE DERKES W
Practice Address - Street 2:ESQ. SAN ANTONIO
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-4841
Practice Address - Country:US
Practice Address - Phone:787-612-4947
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
PR5095104100000X, 1041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool