Healthcare Provider Details

I. General information

NPI: 1780521518
Provider Name (Legal Business Name): ALEXANDRA MONTALVO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE QR 22 URB JARDINES DE ARECIBO
ARECIBO PR
00612-2604
US

IV. Provider business mailing address

URB. VISTA AZUL CALLE 33 CASA BB16
ARECIBO PR
00612-2604
US

V. Phone/Fax

Practice location:
  • Phone: 787-380-1650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17046
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: