Organization Active NPI

Mental Health Solutions of Puerto Rico L.L.C

  • Clinical Psychologist
  • Bayamon, PR
National Provider Identifier
1346655305
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3189 Issued in PR
Legal business name
MENTAL HEALTH SOLUTIONS OF PUERTO RICO L.L.C
Practice address
Carr 174 KM. 0.4 Suite 105-a
Bayamon, PR 00960
Phone
(787) 607-5109
NPI assigned
Jun 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Authorized official

Name
Antonio L Berdecia-Alvarez, PSY.DNPI 1497999833
Title
Doctor
Phone
(787) 607-5109

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 3189 PR Primary

Addresses

Primary practice location

Carr 174 KM. 0.4 Suite 105-a
Bayamon, PR 00960

Mailing address

P.O. Box 607071
PMB 21
Bayamon, PR 00960
Phone (787) 607-5109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141212001417 PR Part B Supplier - Clinic/Group Practice 6204158603 Receives reassigned benefits from 1 practitioner
Practice locations: Bayamon, PR

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.

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403827200000",
    "number": "1346655305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 607071",
            "address_2": "PMB 21",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00960",
            "telephone_number": "787-607-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 174 KM. 0.4 SUITE 105-A",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00960",
            "telephone_number": "787-607-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH SOLUTIONS OF PUERTO RICO L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-27",
        "last_updated": "2014-06-27",
        "status": "A",
        "authorized_official_last_name": "BERDECIA-ALVAREZ",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "787-607-5109",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.