Ivelisse Lissette Castro Lebron, PSYD
Individual provider Active NPI Clinical Psychologist · Catano, PR
NPI 1134523640 · NPPES record last updated Mar 4, 2017
Key facts
- NPI
- 1134523640
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 5776 (PR)
- Practice address
- 168 Ave Barbosa
Catano, PR 00962-4782 - Phone
- (787) 788-4544
- Fax
- (787) 788-4544
- NPI assigned
- Oct 13, 2014
- 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 |
|---|---|---|---|---|
| I20170607001565 | PR | Practitioner - Clinical Psychologist | 5395052328 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5776 | PR | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychology Castro Lebron PSC | Clinical | Current |
Accepting new patients |
Locations
166 Ave Barbosa
Catano, PR 00962
Phone (787) 788-4544
168 Ave Barbosa
Catano, PR 00962
Phone (787) 788-4544
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5776 | PR | Yes |
Addresses
Primary practice location
168 Ave Barbosa
Catano, PR 00962-4782
Mailing address
168 Ave Barbosa
Catano, PR 00962-4782
Phone (787) 788-4544
Other providers in Catano, PR
- Joanne Cardona
- Caribbean Produce Exchange, LLC
- Maria E. Carrascal
- Casita de Amor
- Castro & Rivera Psychological Services, LLC
- CDT Eulalia Kuilan
- Centro de Servicios de Salud de Bayamon
- Centro de Vacunacion de Catano
- Doriam Adelfy Cerda
- Ines Cesareo
All providers in Catano, 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 Mar 4, 2017. 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.