Active NPI
Agustin A Estarellas Velez
- Counseling Psychologist
- Ciales, PR
National Provider Identifier
1104616044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 7792
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 7792 | PR | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro Imec, Inc. | School | Current | 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.