Psy Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PSY CLINIC LLC

Doing business as

Psy Clinic

Practice address

Legacy Office Park
Suite 102
Coto Laurel, PR 00780

Phone

(787) 813-2222

Fax

(787) 813-2222

NPI assigned

Apr 27, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Jackeline Velez, MD

Title

Director

Phone

(787) 813-2222

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Psy Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Grace Kelly Quintas

  • Clinical Psychologist
  • Ponce, PR
  • NPI 1528713914
  Medicare reassignment NPD
• Jackeline Velez Irizarry, PSY.D.

  • Clinical Psychologist
  • Ponce, PR
  • NPI 1902055023
  Medicare reassignment NPD
• Migdalia Flores Castillo, PSYD

  • Clinical Psychologist
  • Coto Laurel, PR
  • NPI 1831581081
  NPD
• Ivelisse Alvarado Santiago

  • Clinical Psychologist
  • Ponce, PR
  • NPI 1457690034
  NPD (past)
• Laura Johanna Colon, PSY.D

  • Clinical Psychologist
  • Coto Laurel, PR
  • NPI 1144345430
  NPD (past)
• Brenda Liz Quintana Montalvo, PSY.D.

  • Clinical Psychologist
  • San Sebastian, PR
  • NPI 1356893788
  NPD (past)

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1366930133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560",
            "city": "MERCEDITA",
            "state": "PR",
            "postal_code": "007150560",
            "telephone_number": "787-813-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LEGACY OFFICE PARK",
            "address_2": "SUITE 102",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "00780",
            "telephone_number": "787-813-2222",
            "fax_number": "787-813-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-27",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "VELEZ",
        "authorized_official_first_name": "JACKELINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-813-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902055023",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psy Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maria Del C Padilla Rodriguez, M.D.
• Pediatric Children's Institute, LLC
• Lasmina Ladis Perea Arismendiz, M.D.
• Damarys Diaz Ponton
• Primary Health Center
• Puerto Rico Oncology, PSC
• Quality Health Services of Puerto Rico Inc (Hospital San Cristobal)
• Quality Medical Care Inc
• Wanda Ivelisse Quiles, MD
• Edwin Antonio Quintana Filippetti, RD

• Clinic/Center in Coto Laurel, PR
• Providers in Coto Laurel, PR by specialty
• Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.