Healthcare Provider Details

I. General information

NPI: 1053247585
Provider Name (Legal Business Name): KARLA KRYSTAL GASCOT NAZARIO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CAROLINA SHOPPING COURT, AV. 65 DE INFANTERIA PISO 6, SUITE 307
CAROLINA PR
00985
US

IV. Provider business mailing address

CAROLINA SHOPPING COURT, AV. 65 DE INFANTERIA PISO 6, SUITE 307
CAROLINA PR
00985
US

V. Phone/Fax

Practice location:
  • Phone: 787-379-2373
  • Fax:
Mailing address:
  • Phone: 787-379-2373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1887
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: