Organization Active NPI

Crece

  • Clinical Psychologist
  • San Juan, PR
National Provider Identifier
1033125273
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0961 Issued in PR
Legal business name
CRECE
Practice address
500 Munoz Rivera Ave
Condominio El Centro II Office 302
San Juan, PR 00917
Phone
(939) 338-8487
Fax
(939) 338-8487
NPI assigned
Jul 31, 2006
Last updated
Nov 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Authorized official

Name
Dr. Mary K. Vidal, PSY. D.
Title
President
Phone
(939) 338-8487

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0961 PR Primary

Addresses

Primary practice location

500 Munoz Rivera Ave
Condominio El Centro II Office 302
San Juan, PR 00917

Mailing address

PO Box 190733
San Juan, PR 00919-0733
Phone (939) 338-8487

Other names 1

  • Centros de Recursos Educativos Especializados y Psicologicos Other name

National Provider Directory

National Provider Directory

Locations

500 Ave Munoz Rivera
Ste 302
San Juan, PR 00918
Phone (939) 338-8487

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1033125273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190733",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009190733",
            "telephone_number": "939-338-8487",
            "fax_number": "939-338-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MUNOZ RIVERA AVE",
            "address_2": "CONDOMINIO EL CENTRO II OFFICE 302",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "939-338-8487",
            "fax_number": "939-338-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRECE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "VIDAL",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "939-338-8487",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY. D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "0961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centros de Recursos Educativos Especializados y Psicologicos",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.