Psylab LLC
Organization Active NPI Counseling Psychologist · Juana Diaz, PR
NPI 1750117883 · NPPES record last updated Sep 13, 2024
Key facts
- NPI
- 1750117883
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counseling Psychologist 103TC1900X
- Legal business name
- PSYLAB LLC
- Practice address
- Urb. Tomas Carrion Maduro
49 Calle 4
Juana Diaz, PR 00795 - Phone
- (787) 553-0895
- NPI assigned
- Sep 13, 2024
- Organization subpart
- No
Authorized official
- Name
- Camille Colon Camacho, PSY.D
- Title
- President/Director
- Phone
- (787) 324-0223
Practitioners 1
-
Camille Marie Colon, PSYD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241212000991 | PR | Part B Supplier - Clinic/Group Practice | 3577099639 |
Receives reassigned benefits from 1 practitioner Practice locations: Juana Diaz, PR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist |
103TC1900X | Yes |
Addresses
Primary practice location
Urb. Tomas Carrion Maduro
49 Calle 4
Juana Diaz, PR 00795
Mailing address
104 Calle Cedro
Est de Juana Diaz
Juana Diaz, PR 00795
Phone (787) 324-0223
Other providers in Juana Diaz, PR
- Patricia Pizarro
- Poetas Medical Service LLC
- Powerup Psychology Inc
- Frances Colon Pratts
- Psicosalud Consultants, LLC.
- Quiromax Centro Quiropractico LLC.
- Ernesto L Ramirez Torres
- Deliz Ramirez
- Jose A Rentas
- Marisol A Reyes Aguirre
All providers in Juana Diaz, PR · Counseling Psychologist in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.