Active NPI
Jackeline Caraballo Rivera
- Counseling Psychologist
- Rio Grande, PR
National Provider Identifier
1154019149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6187
- Practice address
- Urb Cocobeach 210
Calle Manati
Rio Grande, PR 00745 - Phone
- (787) 516-6607
- NPI assigned
- Apr 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 6187 | RI | Primary |
| Counseling Psychologist | 103TC1900X | 6187 | PR |
Addresses
Primary practice location
Urb Cocobeach 210
Calle Manati
Rio Grande, PR 00745
Mailing address
Urb Cocobeach 210 Calle Manati
Calle Manati
Rio Grande, PR 00745
Phone (787) 516-6607
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 |
|---|---|---|---|
| 6187 | RI | MD | Counseling Psychologist |
| 6187 | PR | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682553600000",
"number": "1154019149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB COCOBEACH 210 CALLE MANATI",
"address_2": "CALLE MANATI",
"city": "RIO GRANDE",
"state": "PR",
"postal_code": "00745",
"telephone_number": "787-516-6607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "URB COCOBEACH 210",
"address_2": "CALLE MANATI",
"city": "RIO GRANDE",
"state": "PR",
"postal_code": "00745",
"telephone_number": "787-516-6607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARABALLO RIVERA",
"first_name": "JACKELINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-27",
"last_updated": "2023-04-27",
"certification_date": "2023-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "RI",
"license": "6187",
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PR",
"license": "6187",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Grande, PR
- Elismarie Calero, MS-SLP
- Annmarie Calzada Ortiz
- Caparra Cardiology and Electrophisiology Center PSC
- Caparra Internal Medicine Service Group PSC
- Caparra Sonography and Vascular Studio Center
- Caribe Physicians Plaza Corporation
- Marta Carlo, R.N.
- Carolas Home Care
- Nitzalise Esther Carrasquillo Rodriguez, MD
- Ana Margarita Carrasquillo
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.