Active NPI
Mariela Leon-Velazquez, PH.D.
- Clinical Psychologist
- Ponce, PR
National Provider Identifier
1396970901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3250
- Practice address
- 8133 Calle Martin Corchado
Ponce, PR 00717-1123 - Phone
- (787) 515-9770
- Fax
- (787) 259-9040
- NPI assigned
- May 27, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3250 | PR | Primary |
Addresses
Primary practice location
8133 Calle Martin Corchado
Ponce, PR 00717-1123
Mailing address
8133 Calle Martin Corchado
Ponce, PR 00717-1123
Phone (787) 515-9770
Other names 1
- Dba/Psyche, Servicios Psicologicos
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3250 | PR | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psyche, Servicios Psicologicos | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Ponce, PR
- NPI 1801196787
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488844800000",
"number": "1396970901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8133 CALLE MARTIN CORCHADO",
"city": "PONCE",
"state": "PR",
"postal_code": "007171123",
"telephone_number": "787-515-9770",
"fax_number": "787-259-9040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8133 CALLE MARTIN CORCHADO",
"city": "PONCE",
"state": "PR",
"postal_code": "007171123",
"telephone_number": "787-515-9770",
"fax_number": "787-259-9040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEON-VELAZQUEZ",
"first_name": "MARIELA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-27",
"last_updated": "2017-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "3250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DBA/PSYCHE,",
"last_name": "SERVICIOS PSICOLOGICOS",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.