Individual provider Active NPI

Grecia Noelia Mirabal

  • Clinical Psychologist
  • Lares, PR
National Provider Identifier
1386448470
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8324 Issued in PR
Practice address
Carr. 129 KM. 31.3, Bo. Buenos Aires
Lares, PR 00669
Phone
(787) 249-0593
NPI assigned
Apr 1, 2025
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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 8324 PR Primary

Addresses

Primary practice location

Carr. 129 KM. 31.3, Bo. Buenos Aires
Lares, PR 00669

Mailing address

606 Calle Aragon
San Juan, PR 00920-5315
Phone (787) 470-9858

Other practice location 1

16 Calle Ana Lens De Susoni
Arecibo, PR 00612-4301
Phone (787) 879-1962

Other practice location 2

5 Calle Ramon de Jesus Sierra
Lares, PR 00669
Phone (787) 897-7566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

606 Calle Aragon
San Juan, PR 00920

Carr 129 KM 31
Lares, PR 00669

PO Box
Arecibo, PR 00613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8324PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psicologia Integral Clinica Forense Dra. Norma Gomez Soto CSP Clinical CurrentSince Feb 14, 2026 Accepting new patients

Locations

16 Calle Ana Lens de Susoni
Arecibo, PR 00612
Phone (787) 879-1962

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1386448470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 CALLE ARAGON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009205315",
            "telephone_number": "787-470-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 129 KM. 31.3, BO. BUENOS AIRES",
            "city": "LARES",
            "state": "PR",
            "postal_code": "00669",
            "telephone_number": "787-249-0593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Calle Ana Lens De Susoni",
            "address_purpose": "LOCATION",
            "city": "Arecibo",
            "state": "PR",
            "postal_code": "006124301",
            "country_code": "US",
            "telephone_number": "787-879-1962",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Calle Ramon de Jesus Sierra",
            "address_purpose": "LOCATION",
            "city": "Lares",
            "state": "PR",
            "postal_code": "00669",
            "country_code": "US",
            "telephone_number": "787-897-7566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRABAL",
        "first_name": "GRECIA",
        "middle_name": "NOELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "8324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lares, PR

Sources for this page

Verify at the official NPI Registry.