Mary Liz Baez Rodriguez

Individual provider Active NPI Clinical Social Worker · Penuelas, PR

NPI 1750159240 · NPPES record last updated Dec 14, 2023

Key facts

NPI
1750159240
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
10400 (PR)
Practice address
Calle Jose Vicente #606
Penuelas, PR 00624
Phone
(939) 992-9233
NPI assigned
Dec 14, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240108004214 PR Practitioner - Clinical Social Worker 6103277751 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Transforma Family Group Therapy LLC Clinical Current
since Dec 1, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10400 PR Yes

Addresses

Primary practice location

Calle Jose Vicente #606
Penuelas, PR 00624

Mailing address

Calle Jose Vicente #606
Penuelas, PR 00624
Phone (939) 992-9233

Other providers in Penuelas, PR

All providers in Penuelas, PR · Clinical Social Worker in Puerto Rico

Sources for this page

Verify at the official NPI Registry.