Individual provider Active NPI

Ana Ivelisse Merlos, M.A

  • Counseling Psychologist
  • San Juan, PR
National Provider Identifier
1639424575
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
4292 Issued in PR
Practice address
Ave. Ponce de Leon 735
Torre Auxilio Mutuo Ofic 203
San Juan, PR 00917
Phone
(787) 448-2005
NPI assigned
Jul 17, 2012
Last updated
Jul 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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 4292 PR Primary

Addresses

Primary practice location

Ave. Ponce de Leon 735
Torre Auxilio Mutuo Ofic 203
San Juan, PR 00917

Mailing address

Ave. Ponce de Leon 735
Torre Auxilio Mutuo Ofic 203
San Juan, PR 00917
Phone (787) 448-2005

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4292PRMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1639424575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVE. PONCE DE LEON 735",
            "address_2": "TORRE AUXILIO MUTUO OFIC 203",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "787-448-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. PONCE DE LEON 735",
            "address_2": "TORRE AUXILIO MUTUO OFIC 203",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "787-448-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERLOS",
        "first_name": "ANA",
        "middle_name": "IVELISSE",
        "credential": "M.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "4292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.