Active NPI
Kathleen Angelica Cuellar Prado, MS, EDS
- School Psychologist
- Fort Pierce, FL
National Provider Identifier
1275366924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- SS1857
- Practice address
- 2500 Quincy Ave
Fort Pierce, FL 34947-4766 - Phone
- (786) 261-5497
- NPI assigned
- Aug 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | SS1857 | FL | Primary |
Addresses
Primary practice location
2500 Quincy Ave
Fort Pierce, FL 34947-4766
Mailing address
1500 Centrepark Blvd Apt 317
West Palm Beach, FL 33401-7455
Phone (786) 261-5497
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SS1857 | FL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1275366924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 CENTREPARK BLVD APT 317",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334017455",
"telephone_number": "786-261-5497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 QUINCY AVE",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349474766",
"telephone_number": "786-261-5497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUELLAR PRADO",
"first_name": "KATHLEEN",
"middle_name": "ANGELICA",
"credential": "MS, EDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-20",
"last_updated": "2024-11-05",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "FL",
"license": "SS1857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.