Joan Marie Acosta Negron
Individual provider Active NPI Clinical Psychologist · Villalba, PR
NPI 1114616695 · NPPES record last updated May 2, 2023
Key facts
- NPI
- 1114616695
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 3488 (PR)
- Practice address
- Bo Tierra Santa
Carr 149 KM 582 Primer Piso
Villalba, PR 00766 - Phone
- (787) 517-9493
- NPI assigned
- May 2, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230616002687 | PR | Practitioner - Clinical Psychologist | 8325406754 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3488 | PR | MD | Clinical Child & Adolescent Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neuroeducational Consultans LLC | Clinical | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3488 | PR | |
| Clinical Psychologist |
103TC0700X | 3488 | PR | Yes |
| Counseling Psychologist | 103TC1900X | 3488 | PR | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 3488 | PR |
Addresses
Primary practice location
Bo Tierra Santa
Carr 149 KM 582 Primer Piso
Villalba, PR 00766
Mailing address
Bo Tierra Santa
Carr 149 KM 582 Primer Piso
Villalba, PR 00766
Phone (787) 517-9493
Other practice location 1
Hacienda El Mayoral
Calle Principal #6
Villalba, PR 00766-0076
Phone (787) 569-7459
Other providers in Villalba, PR
- Juan Alberto Alicea
- Karina Jolene Alvarado Bello
- Jesselyn Alvarado Marrero
- Luzianne Alvarado Santiago
- Jozairy Alvarez Irizarry
All providers in Villalba, PR · Clinical Psychologist in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.