Individual provider Active NPI

Enrique L. Colon de Leon, PSYCHOLOGY DOCTOR

  • Counseling Psychologist
  • San Juan, PR
National Provider Identifier
1689161374
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
2954 Issued in PR
Practice address
607 Calle Julio Gonzalez
San Juan, PR 00924-3717
Phone
(787) 639-3231
NPI assigned
Apr 18, 2018
Last updated
Apr 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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 2954 PR Primary

Addresses

Primary practice location

607 Calle Julio Gonzalez
San Juan, PR 00924-3717

Mailing address

PO Box 11752
San Juan, PR 00910-2852
Phone (787) 639-3231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190617003106 PR Practitioner - Psychologist Billing Independently 9931432366 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2954PRMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Morovis Community Health Center, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Morovis Community Health Center, Inc. Current Accepting new patients
Morovis Community Health Center, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Morovis Community Health Center, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Morovis Community Health Center, Inc. Past Accepting new patients

Locations

2 Calle Patron
Morovis, PR 00687
Phone (787) 862-3667

460 Carr 2
#302
Vega Alta, PR 00692

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1689161374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11752",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009102852",
            "telephone_number": "787-639-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 CALLE JULIO GONZALEZ",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009243717",
            "telephone_number": "787-639-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON DE LEON",
        "first_name": "ENRIQUE",
        "middle_name": "L.",
        "credential": "PSYCHOLOGY DOCTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "2954",
            "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 Apr 18, 2018; 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.