Healthcare Provider Details

I. General information

NPI: 1982914727
Provider Name (Legal Business Name): SARA RICO CSW,MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. LOS AIRES F8
ARECIBO PR
00612
US

IV. Provider business mailing address

URB. LOS AIRES #198 CALLE NEON CASA F- 8
ARECIBO PR
00612
US

V. Phone/Fax

Practice location:
  • Phone: 787-485-5543
  • Fax: 787-884-3673
Mailing address:
  • Phone: 939-276-9181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9315
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7599
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: