Provider Demographics
NPI:1235944406
Name:IRIZARRY BARRETO, JESSICA (MA LPC-PR)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:IRIZARRY BARRETO
Suffix:
Gender:F
Credentials:MA LPC-PR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-0050
Mailing Address - Country:US
Mailing Address - Phone:939-279-1762
Mailing Address - Fax:
Practice Address - Street 1:99 CALLE PIMENTEL STE 1
Practice Address - Street 2:#50
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-9998
Practice Address - Country:US
Practice Address - Phone:939-279-1762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8170103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling