Camille Marie Colon, PSYD
Individual provider Active NPI Counseling Psychologist · Juana Diaz, PR
NPI 1346973633 · NPPES record last updated Sep 15, 2024
Key facts
- NPI
- 1346973633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counseling Psychologist 103TC1900X
- License
- 5653 (PR)
- Practice address
- Urb. Tomas Carrion Maduro
49 Calle 4
Juana Diaz, PR 00795 - Phone
- (787) 553-0895
- NPI assigned
- Jul 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241212001082 | PR | Practitioner - Psychologist Billing Independently | 4486180544 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5653 | PR | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psylab LLC | Counseling | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 5653 | PR | Yes |
Addresses
Primary practice location
Urb. Tomas Carrion Maduro
49 Calle 4
Juana Diaz, PR 00795
Mailing address
Est de Juana Diaz
104 Calle Cedro
Juana Diaz, PR 00795
Phone (787) 324-0223
Other providers in Juana Diaz, PR
- Brenda Luz Colon Arzola
- Jose Manuel Colon Gaztambide Sr.
- Cristina Isabel Colon Negron
- Jesmarie Colon Rodriguez
- Marlyn Lynette Colon Toro
- Erika Colon
- Gloria M Colon
- Nicole Marie Colon
- Pablo Luis Colon Jr.
- Paola Marie Colon
All providers in Juana Diaz, PR · Counseling 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 Sep 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.