NPIMap

Organization Active NPI

Ebao Mental Health Clinic, LLC.

  • Psychologist
  • Arecibo, PR
National Provider Identifier
1497637706
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
EBAO MENTAL HEALTH CLINIC, LLC.
Practice address
65 Ave Barbosa Ste 103
Arecibo, PR 00612-2746
Phone
(939) 263-3462
NPI assigned
Jul 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Authorized official

Name
Edwin Alonso Olmo, MANPI 1841180213
Title
President
Phone
(787) 944-5516

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

65 Ave Barbosa Ste 103
Arecibo, PR 00612-2746

Mailing address

65 Ave Barbosa Ste 103
Arecibo, PR 00612-2746
Phone (939) 263-3462

National Provider Directory

National Provider Directory

Locations

65 Ave Barbosa
Ste 103
Arecibo, PR 00612
Phone (787) 562-5757

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1753401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1497637706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 AVE BARBOSA STE 103",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006122746",
            "telephone_number": "939-263-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 AVE BARBOSA STE 103",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006122746",
            "telephone_number": "939-263-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBAO MENTAL HEALTH CLINIC, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-25",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "ALONSO OLMO",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-944-5516",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.