Samiris Collazo-Rodriguez, PSY.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

5652 Issued in PR

Practice address

51 Calle Escute
Juncos, PR 00777-3417

Phone

(787) 561-3585

NPI assigned

Mar 31, 2017

Last updated

Feb 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Servicios Psicologicos del Valenciano LLC

  • Psychologist
  • Juncos, PR
  • NPI 1568352433
  NPD (past)

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1639601495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 CALLE DAGUAO",
            "address_2": "URB VILLAS DE BUENAVENTURA",
            "city": "YABUCOA",
            "state": "PR",
            "postal_code": "00767",
            "telephone_number": "787-951-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 CALLE ESCUTE",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007773417",
            "telephone_number": "787-561-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZO-RODRIGUEZ",
        "first_name": "SAMIRIS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "5652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Juncos, PR
• Providers in Juncos, PR by specialty
• Counseling Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.