Individual provider Active NPI

Sherly Marie Perez Rivera

  • Clinical Psychologist
  • San Juan, PR
National Provider Identifier
1245919984
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8240 Issued in PR
Practice address
151 Calle de la Tanca
San Juan, PR 00901-1412
Phone
(787) 993-3585
NPI assigned
Jul 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 8240 PR Primary
Student in an Organized Health Care Education/Training Program 390200000X PR

Addresses

Primary practice location

151 Calle de la Tanca
San Juan, PR 00901-1412

Mailing address

151 Calle de la Tanca
San Juan, PR 00901-1412
Phone (787) 993-3585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250303000587 PR Practitioner - Clinical Psychologist 9133640576 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8240PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mente Sana LLC Clinical CurrentSince Feb 1, 2025 Accepting new patients

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": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1245919984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 CALLE DE LA TANCA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009011412",
            "telephone_number": "787-993-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 CALLE DE LA TANCA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009011412",
            "telephone_number": "787-993-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ RIVERA",
        "first_name": "SHERLY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "8240",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.