Healthcare Provider Details

I. General information

NPI: 1659940740
Provider Name (Legal Business Name): BELMARYLIES ALICEA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BELMARYLIES ALICEA MSW

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 CALLE TEODOMIRO DELFAUS
JUNCOS PR
00777-3336
US

IV. Provider business mailing address

14 CALLE PALES
SANTA ISABEL PR
00757-3002
US

V. Phone/Fax

Practice location:
  • Phone: 939-253-8098
  • Fax:
Mailing address:
  • Phone: 939-253-8098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14716
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: