Provider Demographics
NPI:1194037671
Name:BAERGA, IVETTE (PSYD)
Entity type:Individual
Prefix:MRS
First Name:IVETTE
Middle Name:
Last Name:BAERGA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 CALLE PERLA
Mailing Address - Street 2:URBANIZACION ESTANCIAS
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-2092
Mailing Address - Country:US
Mailing Address - Phone:787-340-1815
Mailing Address - Fax:
Practice Address - Street 1:CALLE MARGINAL 706
Practice Address - Street 2:FUENTE TOWN CENTER LOCAL 221 224
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-6045
Practice Address - Country:US
Practice Address - Phone:787-704-0705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR103991041C0700X
PR8103103TC0700X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)