NPIMap

Organization Active NPI

Ednaliz Camacho Montes

  • Adolescent and Children Mental Health Clinic/Center
  • Guayama, PR
National Provider Identifier
1235528209
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
5646 Issued in PR
Legal business name
EDNALIZ CAMACHO MONTES
Practice address
3 Ave Los Veteranos B14
Villa Rosa
Guayama, PR 00784
Phone
(787) 484-4168
NPI assigned
Jan 14, 2015
Last updated
Feb 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Authorized official

Name
Ednaliz Camacho Montes, M.A.NPI 1811487531
Title
Psycological Counselor
Phone
(787) 597-7967

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 5646 PR
Adolescent and Children Mental Health Clinic/Center 261QM0855X 5646 PR Primary

Addresses

Primary practice location

3 Ave Los Veteranos B14
Villa Rosa
Guayama, PR 00784

Mailing address

HC 1 Box 2329
Maunabo, PR 00707-7418
Phone (785) 977-9567

Other names 1

  • Clinica Pies Descalzos Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1235528209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 2329",
            "city": "MAUNABO",
            "state": "PR",
            "postal_code": "007077418",
            "telephone_number": "785-977-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 AVE LOS VETERANOS B14",
            "address_2": "VILLA ROSA",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-484-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDNALIZ CAMACHO MONTES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-14",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "CAMACHO MONTES",
        "authorized_official_first_name": "EDNALIZ",
        "authorized_official_title_or_position": "PSYCOLOGICAL COUNSELOR",
        "authorized_official_telephone_number": "787-597-7967",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PR",
            "license": "5646",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PR",
            "license": "5646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Pies Descalzos",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Guayama, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; 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.