Provider Demographics
NPI:1548967938
Name:BRENS, VICTOR A (MSW)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:A
Last Name:BRENS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5GG7 CALLE PARQUE SAN JOSE
Mailing Address - Street 2:URB. VILLA FONTANA PARK
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983
Mailing Address - Country:US
Mailing Address - Phone:939-655-3777
Mailing Address - Fax:
Practice Address - Street 1:400 AVE FD ROOSEVELT STE 501
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2163
Practice Address - Country:US
Practice Address - Phone:939-655-3777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR256341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical