Katherine Malavenda, LPC, M.ED.

Individual provider Active NPI Professional Counselor · Aguadilla, PR

NPI 1346662905 · NPPES record last updated Aug 4, 2016

Key facts

NPI
1346662905
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
4011 (PR)
Practice address
310A Calle Guard
Ramey
Aguadilla, PR 00603
Phone
(252) 626-1316
NPI assigned
Jan 15, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
304149NCMDProfessional Counselor
4011PRMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4011 PR Yes
Professional Counselor 101YP2500X 304149 NC

Addresses

Primary practice location

310A Calle Guard
Ramey
Aguadilla, PR 00603

Mailing address

PO Box 5968
PMB 364
San Antonio, PR 00690
Phone (252) 626-1316

Other identifiers

IdentifierTypeStateIssuer
12543005OtherPRCAHQ

Other providers in Aguadilla, PR

All providers in Aguadilla, PR · Professional Counselor in Puerto Rico

Sources for this page

Verify at the official NPI Registry.