Provider Demographics
NPI:1770462681
Name:FEBRES-JIMERSON, LIZ O (MSW)
Entity type:Individual
Prefix:
First Name:LIZ
Middle Name:O
Last Name:FEBRES-JIMERSON
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 79872
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-9872
Mailing Address - Country:US
Mailing Address - Phone:413-636-8110
Mailing Address - Fax:
Practice Address - Street 1:400 AVE A APT 94
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4135
Practice Address - Country:US
Practice Address - Phone:413-636-8110
Practice Address - Fax:413-636-8110
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR169261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical