Ivan Raul Alicea, PSICOLOGO
Individual provider Active NPI Clinical Psychologist · Mayaguez, PR
NPI 1306098504 · NPPES record last updated Oct 21, 2008
Key facts
- NPI
- 1306098504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 2517 (PR)
- Practice address
- Centro Salud Mental de Mayaguez
410 Ave Hostos Suite 7
Mayaguez, PR 00682-1522 - Phone
- (787) 831-3714
- Fax
- (787) 831-3714
- NPI assigned
- Oct 21, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2517 | PR | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2517 | PR | Yes |
Addresses
Primary practice location
Centro Salud Mental de Mayaguez
410 Ave Hostos Suite 7
Mayaguez, PR 00682-1522
Mailing address
Quintas de Cabo Rojo #168
Calle Cisne
Cabo Rojo, PR 00623
Phone (787) 254-0277
Other providers in Mayaguez, PR
- Ana Teresa Alemany
- Edmundo Juan Alemany
- Juan Carlos Alemany
- Melissa Alers
- Alfredo Ramirez Justiniano Nefrologo CSP
- All Medical Supply Inc
- Diana L Allende
- Robert Miguel Almanzar Nunez
- Gustavo Jesus Almodovar-Mercado
- Alberto Ivan Almodovar
All providers in Mayaguez, 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 Oct 21, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.