Provider Demographics
NPI:1932064953
Name:MARRERO, JACOB ABDEEL (LCSW)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:ABDEEL
Last Name:MARRERO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 CALLE CRUZ MARIA
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-7571
Mailing Address - Country:US
Mailing Address - Phone:787-519-8902
Mailing Address - Fax:
Practice Address - Street 1:566 CALLE CRUZ MARIA
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-7571
Practice Address - Country:US
Practice Address - Phone:787-519-8902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-22
Last Update Date:2025-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR168821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical