Individual provider Active NPI

Stephany Vyann Velez Salas

  • Clinical Psychologist
  • Isabela, PR
National Provider Identifier
1366077455
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6594 Issued in PR
Practice address
300 Ave Noel Estrada
Isabela, PR 00662-3275
Phone
(787) 669-3815
NPI assigned
Mar 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6594 PR Primary

Addresses

Primary practice location

300 Ave Noel Estrada
Isabela, PR 00662-3275

Mailing address

105 Calle Caoba
Isabela, PR 00662-3937
Phone (787) 806-7144

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
I20200330001066 PR Practitioner - Clinical Psychologist 4587093455 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Umbrella of Purpose and Hope LLC Clinical CurrentSince Mar 19, 2020 Accepting new patients

Locations

300 Ave Noel Estrada
Isabela, PR 00662
Phone (787) 546-3383

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": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1366077455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CALLE CAOBA",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006623937",
            "telephone_number": "787-806-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 AVE NOEL ESTRADA",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006623275",
            "telephone_number": "787-669-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELEZ SALAS",
        "first_name": "STEPHANY",
        "middle_name": "VYANN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Isabela, PR

Sources for this page

Verify at the official NPI Registry.