Psychological Wellness Center LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PSYCHOLOGICAL WELLNESS CENTER LLC

Practice address

Carr.PR-54 Int. Ramal 7711
Bo. Pozo Hondo
Guayama, PR 00784

Phone

(787) 246-2827

NPI assigned

Feb 6, 2023

Last updated

Feb 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marielly Hernandez Fernandez, PHDNPI 1043892714

Title

Clinical Psychology

Phone

(787) 246-2827

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Marielly Hernandez Fernandez, PHD

  • Clinical Psychologist
  • Guayama, PR
  • NPI 1043892714
  NPD Authorized official

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1659077295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3372",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "007853372",
            "telephone_number": "787-246-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR.PR-54 INT. RAMAL 7711",
            "address_2": "BO. POZO HONDO",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "00784",
            "telephone_number": "787-246-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ FERNANDEZ",
        "authorized_official_first_name": "MARIELLY",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGY",
        "authorized_official_telephone_number": "787-246-2827",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "4519251",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Guayama, PR
• Providers in Guayama, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.