Individual provider Active NPI

Selysmarie Martinez Gonzalez, PSYD

  • Clinical Psychologist
  • Aguadilla, PR
National Provider Identifier
1700323359
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6383 Issued in PR
Practice address
Buen Samaritano Western & Professional Plaza
2DO Nivel Ala 3 Ave. Severiano Cuevas #18 Ste. 6
Aguadilla, PR 00603
Phone
(787) 560-6237
NPI assigned
Jan 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 6383 PR
Health Service Psychologist 103TH0100X 6383 PR
Counselor 101Y00000X
Adult Development & Aging Psychologist 103TA0700X 6383 PR
Clinical Psychologist 103TC0700X 6383 PR Primary
Health Psychologist 103TH0004X 6383 PR

Addresses

Primary practice location

Buen Samaritano Western & Professional Plaza
2DO Nivel Ala 3 Ave. Severiano Cuevas #18 Ste. 6
Aguadilla, PR 00603

Mailing address

207B Circulo C
Aguadilla, PR 00603-1246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230501001744 PR Practitioner - Clinical Psychologist 0446615249 Reassigns benefits to 1 organization
Practice locations: Aguadilla, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mente Renovada Centro de Intervencion Clinica Social CurrentSince Apr 1, 2023 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1700323359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207B CIRCULO C",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006031246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUEN SAMARITANO WESTERN & PROFESSIONAL PLAZA",
            "address_2": "2DO NIVEL ALA 3 AVE. SEVERIANO CUEVAS #18 STE. 6",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "787-560-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ GONZALEZ",
        "first_name": "SELYSMARIE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-20",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PR",
            "license": "6383",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "PR",
            "license": "6383",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "PR",
            "license": "6383",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6383",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "PR",
            "license": "6383",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguadilla, PR

Sources for this page

Verify at the official NPI Registry.