MEDICARE: DAPHNE LIZ PARRILLA BETANCOURT LCSW,MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	16551	PR
2	104100000X	Social Worker	10721	CT
3	104100000X	Social Worker	26075	PR

General Provider Information

NPI Number	:	1215639224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAPHNE LIZ PARRILLA BETANCOURT LCSW,MSW

Provider Business Mailing Address
First Line	:	73 CALLE ZUMBADOR
Second Line	:	VILLA REALIDAD
City	:	RIO GRANDE
State	:	PR
Zip	:	00745-9628
Country	:	US
Telephone Number	:	939-349-6509
Fax Number	:

Provider Business Practice Location Address
First Line	:	73 CALLE ZUMBADOR
Second Line	:
City	:	RIO GRANDE
State	:	PR
Zip	:	00745-9628
Country	:	US
Telephone Number	:	939-349-6509
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	01/26/2026

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