Individual provider Active NPI

Agustin A Estarellas Velez

  • Counseling Psychologist
  • Ciales, PR
National Provider Identifier
1104616044
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
7792 Issued in PR
Practice address
6 Calle Jose de Diego
Ciales, PR 00638-3214
Phone
(787) 871-2211
NPI assigned
May 12, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 7792 PR
Counseling Psychologist 103TC1900X 7792 PR Primary

Addresses

Primary practice location

6 Calle Jose de Diego
Ciales, PR 00638-3214

Mailing address

6 Calle Jose de Diego
Ciales, PR 00638-3214
Phone (787) 871-2211

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
7792PRMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Imec, Inc. School CurrentSince May 18, 2025 Accepting new patients

Locations

6 Calle Jose de Diego
Ciales, PR 00638
Phone (787) 466-6670

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1104616044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CALLE JOSE DE DIEGO",
            "city": "CIALES",
            "state": "PR",
            "postal_code": "006383214",
            "telephone_number": "787-871-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CALLE JOSE DE DIEGO",
            "city": "CIALES",
            "state": "PR",
            "postal_code": "006383214",
            "telephone_number": "787-871-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTARELLAS VELEZ",
        "first_name": "AGUSTIN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "PR",
            "license": "7792",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "7792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ciales, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.