Luis Gabriel Illades | Brooklyn, NY • PECOS Search

Luis Gabriel Illades

Social Worker

Behavioral Health & Social Service Providers

190 N 10th St Ste 203, Brooklyn, NY 11211-9317

(646) 779-7172 (415) 845-4964

PECOS Enrollment

Based on the most recent information from CMS, provider Luis Gabriel Illades does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1982348058
Provider Type
Individual
Full Name
Illades, Luis Gabriel
Title
Mr.
Credential
CASAC, LMSW

Gender
Male
Sole Proprietor
Yes
Enumeration Date
4/25/2022
Last Updated
4/25/2022

Contact Information

Practice Location

190 N 10th St Ste 203, Brooklyn, NY 11211-9317

Unlisted Fax

Mailing Location

827 N Franklin St, Wilmington, DE 19806-4626

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 132867001 New York