Individual provider Active NPI

Maritza Rodriguez-Lazu, PSY.D., CGG

  • Counseling Psychologist
  • San Juan, PR
National Provider Identifier
1407320484
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
5988 Issued in PR
Practice address
Chirino Office Plaza Carr. 8838 #1739
Suite 204L Bo. Monacillos
San Juan, PR 00926-2745
Phone
(939) 270-0902
NPI assigned
Jan 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 5988 PR Primary

Addresses

Primary practice location

Chirino Office Plaza Carr. 8838 #1739
Suite 204L Bo. Monacillos
San Juan, PR 00926-2745

Mailing address

PO Box 262294
San Juan, PR 00926-2655
Phone (939) 270-0902

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
I20201109000163 PR Practitioner - Clinical Psychologist 0648680397 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Carr 8838 Ave Ponce de Leon
Bo. Monacillos 1739 Suite 204L
San Juan, PR 00926-2745
Phone (787) 249-7174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5988PRMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Facilidades Medicas Asociadas Corp. 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.

NPI Registry JSON

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1407320484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 262294",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009262655",
            "telephone_number": "939-270-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHIRINO OFFICE PLAZA CARR. 8838 #1739",
            "address_2": "SUITE 204L BO. MONACILLOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009262745",
            "telephone_number": "939-270-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-LAZU",
        "first_name": "MARITZA",
        "name_prefix": "Dr.",
        "credential": "PSY.D., CGG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-14",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "5988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.