Provider Demographics
NPI:1548935430
Name:BARRIOS, LUIS (PHD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:
Last Name:BARRIOS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13332 129TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-3306
Mailing Address - Country:US
Mailing Address - Phone:917-697-7056
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA EDUARDO CONDE
Practice Address - Street 2:#129
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00915-3621
Practice Address - Country:US
Practice Address - Phone:917-697-7056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR301103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty