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General NPI Number Information
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NPI Number | 1851641054
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Entity Type | Individual
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Provider Name | LOURDES SANTIAGO-GELY PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 900 W MAGNOLIA ST
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City | KISSIMMEE
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State | FL
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Zip | 34741-4117
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Country | US
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Telephone | 800-457-4573
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Fax | 800-443-6422
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Provider Business Mailing Address
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Address Line | 200 HYGEIA DR STE 2300
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City | NEWARK
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State | DE
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Zip | 19713-2049
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 002813
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY12650
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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