Provider Demographics
NPI:1982914727
Name:RICO, SARA (CSW,MSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:RICO
Suffix:
Gender:F
Credentials:CSW,MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. LOS AIRES
Mailing Address - Street 2:#198 CALLE NEON CASA F- 8
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:939-276-9181
Mailing Address - Fax:
Practice Address - Street 1:URB. LOS AIRES
Practice Address - Street 2:F8
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-485-5543
Practice Address - Fax:787-884-3673
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR93151041C0700X
PR7599103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty