Gabriela Enid Luciano, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5956 Issued in PR

Practice address

64 Calle San Miguel
Guanica, PR 00653-2809

Phone

(787) 673-8394

NPI assigned

Nov 1, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clinica Psicologica Las Mirlas LLC

  • Clinical Psychologist
  • Guanica, PR
  • NPI 1104485077
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1073025995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 939",
            "city": "ENSENADA",
            "state": "PR",
            "postal_code": "006470939",
            "telephone_number": "939-865-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 CALLE SAN MIGUEL",
            "city": "GUANICA",
            "state": "PR",
            "postal_code": "006532809",
            "telephone_number": "787-673-8394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIANO",
        "first_name": "GABRIELA",
        "middle_name": "ENID",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "5956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ismael Enrique Jusino-McDougall, MD
• Lab Santana LLC
• Laboratorio Clinico Santana
• Lisbeth Lugo Sr
• Loang Corp
• Lisbeth Lugo
• Maria R. Suarez MD,CSP
• Jackeline Mattei, O.T.
• Aiesha-Agyemarai Medina, PHD
• Wilson Mendez, OPTICIAN

• Clinical Psychologist in Guanica, PR
• Providers in Guanica, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.