Healthcare Provider Details

I. General information

NPI: 1144863796
Provider Name (Legal Business Name): MYRNA ELIAS NARVAEZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2019
Last Update Date: 08/28/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 613 KM 5.2 INTERIOR TETUAN
UTUADO PR
00641-1726
US

IV. Provider business mailing address

PO BOX 1726
UTUADO PR
00641-1726
US

V. Phone/Fax

Practice location:
  • Phone: 939-904-6066
  • Fax:
Mailing address:
  • Phone: 939-904-6066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4328
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: