Sepulveda Psychological Clinic LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SEPULVEDA PSYCHOLOGICAL CLINIC LLC

Practice address

Dufresne 19 Suite 1
Humacao, PR 00791

Phone

(787) 381-6613

NPI assigned

Jul 28, 2023

Organization subpart

No

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

Authorized official

Name

Carmen I Sepulveda, PSYDNPI 1437368883

Title

Owner

Phone

(787) 381-6613

Specialties & licenses 2

Addresses

Other names 1

• Sepulveda Psychological Clinic LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carmen I Sepulveda, PSYD

  • Clinical Psychologist
  • Humacao, PR
  • NPI 1437368883
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1033890348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB PALMAS PLANTATION",
            "address_2": "101 FAIRWAY DR",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007916120",
            "telephone_number": "787-381-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DUFRESNE 19 SUITE 1",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-381-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEPULVEDA PSYCHOLOGICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-28",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "SEPULVEDA",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-381-6613",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sepulveda Psychological Clinic LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Lynne Pamela Schwartz-Rodriguez, D.D.S.
• Jamilisse Segarra-Villafane, MD
• Sepulveda Endocrine & Diabetes Center LLC
• Luis Ruben Sepulveda Garcia
• Iliana Sepulveda Montes, PSYD
• Coralys Milagros Sepulveda Rivera, RDN
• Ramon Sepulveda-Abreu, M.D.
• Carmen I Sepulveda, PSYD
• Josean Sepulveda, MD
• Lillian M Sepulveda, RPH

• Mental Health Clinic/Center (Including Community Mental Health Center) in Humacao, PR
• Providers in Humacao, PR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.