Organization Active NPI

Clinica Psicologica del Sureste LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Guayama, PR
National Provider Identifier
1619821949
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CLINICA PSICOLOGICA DEL SURESTE LLC
Practice address
Calle Duque #29
Esquina San Jose
Guayama, PR 00784
Phone
(787) 597-7967
NPI assigned
Feb 24, 2026
Last updated
Feb 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Ednaliz Camacho, PSYC
Title
President
Phone
(787) 597-7967

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

Calle Duque #29
Esquina San Jose
Guayama, PR 00784

Mailing address

5015 Calle Punta Tuna
Villas del Faro 410
Maunabo, PR 00707
Phone (787) 597-7967

National Provider Directory

National Provider Directory

Locations

29 Calle Duque
Guayama, PR 00784
Phone (787) 597-7967

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1771891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1619821949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 CALLE PUNTA TUNA",
            "address_2": "VILLAS DEL FARO 410",
            "city": "MAUNABO",
            "state": "PR",
            "postal_code": "00707",
            "telephone_number": "787-597-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE DUQUE #29",
            "address_2": "ESQUINA SAN JOSE",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-597-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA PSICOLOGICA DEL SURESTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-24",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "CAMACHO",
        "authorized_official_first_name": "EDNALIZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-597-7967",
        "authorized_official_credential": "PSYC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guayama, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.