Active NPI
Carelys Pena, M.A.
- Counseling Psychologist
- Aguadilla, PR
National Provider Identifier
1366997595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 5703
- Practice address
- 109 Lighthouse Dr
Aguadilla, PR 00603-1327 - Phone
- (787) 673-0599
- NPI assigned
- Aug 17, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 5703 | PR | Primary |
Addresses
Primary practice location
109 Lighthouse Dr
Aguadilla, PR 00603-1327
Mailing address
Carr 107 KM 1.1
Local B
Aguadilla, PR 00603-9999
Phone (787) 673-0599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210707001045 | PR | Practitioner - Psychologist Billing Independently | 7517369044 | Practice locations: Aguadilla, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5703 | PR | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1366997595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CARR 107 KM 1.1",
"address_2": "LOCAL B",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "006039999",
"telephone_number": "787-673-0599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 LIGHTHOUSE DR",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "006031327",
"telephone_number": "787-673-0599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "CARELYS",
"name_prefix": "Ms.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-17",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PR",
"license": "5703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aguadilla, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.