Provider Demographics
NPI:1124826698
Name:SANTIAGO, AUREA III (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AUREA
Middle Name:
Last Name:SANTIAGO
Suffix:III
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 CALLE DIEGO ZALDUONDO
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-4729
Mailing Address - Country:US
Mailing Address - Phone:787-980-8162
Mailing Address - Fax:
Practice Address - Street 1:165 CALLE DIEGO ZALDUONDO
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4729
Practice Address - Country:US
Practice Address - Phone:787-980-8162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR166581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical