Individual provider Active NPI

Militza Lopez Feliciano, PSYCHOLOGIST

  • Counseling Psychologist
  • San Sebastian, PR
National Provider Identifier
1356821185
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
005363 Issued in PR
Practice address
4160 Ave Arcadio Estrada Ste 209
San Sebastian, PR 00685-3211
Phone
(787) 908-0908
NPI assigned
Aug 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 005363 PR Primary

Addresses

Primary practice location

4160 Ave Arcadio Estrada Ste 209
San Sebastian, PR 00685-3211

Mailing address

HC 1 Box 11663
San Sebastian, PR 00685-6473
Phone (787) 908-0908

Other names 1

  • Militza Lopez Feliciano Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230616003377 PR Practitioner - Clinical Psychologist 0941536650 Practice locations: Aguadilla, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005363PRMDCounseling Psychologist
5363PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shapes PR LLC CurrentSince Feb 16, 2020 Accepting new patients

Locations

4160 Ave Arcadio Estrada
Ste 209
San Sebastian, PR 00685
Phone (787) 908-0908

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1356821185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 11663",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006856473",
            "telephone_number": "787-908-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 AVE ARCADIO ESTRADA STE 209",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006853211",
            "telephone_number": "787-908-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ FELICIANO",
        "first_name": "MILITZA",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "005363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILITZA",
            "last_name": "LOPEZ FELICIANO",
            "credential": "PSYCHOLOGIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Sebastian, PR

Sources for this page

Verify at the official NPI Registry.