Individual provider Active NPI

Mariely Maldonado

  • Addiction (Substance Use Disorder) Counselor
  • Santa Isabel, PR
National Provider Identifier
1023324191
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
623 Issued in PR
Practice address
Bo Jauca Calle 5 Num 367
Santa Isabel, PR 00757
Phone
(787) 486-9387
Fax
(787) 844-4130
NPI assigned
Aug 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 623 PR Primary

Addresses

Primary practice location

Bo Jauca Calle 5 Num 367
Santa Isabel, PR 00757

Mailing address

Bo Jauca Calle 5 Num 367
Santa Isabel, PR 00757
Phone (787) 486-9387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
623PRMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1023324191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BO JAUCA CALLE 5 NUM 367",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "00757",
            "telephone_number": "787-486-9387",
            "fax_number": "787-844-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO JAUCA CALLE 5 NUM 367",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "00757",
            "telephone_number": "787-486-9387",
            "fax_number": "787-844-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "MARIELY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PR",
            "license": "623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Isabel, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.