Lucery Medina-Laureano, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

1862 Issued in PR

Practice address

411 Calle Lisa
San Demetrio
Vega Baja, PR 00693-3549

Phone

(787) 448-9374

NPI assigned

Apr 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336369610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ROAD 155 CORNER ROAD. 643 KM 58.3",
            "address_2": "BO. PUGNADO",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006933549",
            "telephone_number": "787-448-9374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CALLE LISA",
            "address_2": "SAN DEMETRIO",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006933549",
            "telephone_number": "787-448-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA-LAUREANO",
        "first_name": "LUCERY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PR",
            "license": "1862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Child & Adolescent Psychologist in Vega Baja, PR
• Providers in Vega Baja, PR by specialty
• Clinical Child & Adolescent Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.