Active NPI
Nellynnette Acevedo, M.A.
- Counseling Psychologist
- San Juan, PR
National Provider Identifier
1699083121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 3724
- Practice address
- 1007 Ave Munoz Rivera
304 Cond. Darlington
San Juan, PR 00925-2717 - Phone
- (787) 930-3029
- NPI assigned
- Sep 17, 2010
- Last updated
- Sep 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 3724 | PR | Primary |
Addresses
Primary practice location
1007 Ave Munoz Rivera
304 Cond. Darlington
San Juan, PR 00925-2717
Mailing address
PO Box 678
Yabucoa, PR 00767-0678
Phone (787) 930-3029
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0421 | Other | PR | APS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3724 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284681600000",
"number": "1699083121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 678",
"city": "YABUCOA",
"state": "PR",
"postal_code": "007670678",
"telephone_number": "787-930-3029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 AVE MUNOZ RIVERA",
"address_2": "304 COND. DARLINGTON",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009252717",
"telephone_number": "787-930-3029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACEVEDO",
"first_name": "NELLYNNETTE",
"name_prefix": "Mrs.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-17",
"last_updated": "2010-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PR",
"license": "3724",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APS",
"identifier": "0421",
"state": "PR"
}
],
"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 Sep 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.