Individual provider Active NPI

Gustavo Segura Hernandez, PHD, MP, ABPP

  • Prescribing (Medical) Psychologist
  • Monroe, LA
National Provider Identifier
1760799886
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
334132 Issued in LA
Practice address
1502 Stubbs Ave
Monroe, LA 71201-5628
Phone
(727) 834-0034
Fax
(318) 323-8757
NPI assigned
Sep 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X PY9350 FL
Clinical Psychologist 103TC0700X PY9350 FL
Prescribing (Medical) Psychologist 103TP0016X 334132 LA Primary

Addresses

Primary practice location

1502 Stubbs Ave
Monroe, LA 71201-5628

Mailing address

1340 Poydras St Ste 1770
New Orleans, LA 70112-5204
Phone (727) 834-0034

Other practice location 1

1645 Palm Beach Lakes Blvd Ste 1200
West Palm Beach, FL 33401-2214
Phone (727) 834-0034

Other practice location 2

1340 Poydras St Ste 1770
New Orleans, LA 70112-5204
Phone (727) 834-0034

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY9350FLMDCognitive & Behavioral Psychologist
334132LAMDPrescribing (Medical) Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pelicano, LLC Cognitive & Behavioral Current Accepting new patients

Locations

1645 Palm Beach Lakes Blvd
Ste 1200
West Palm Beach, FL 33401
Phone (561) 257-1877

1340 Poydras St
Ste 1770
New Orleans, LA 70112
Phone (561) 897-3384

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": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1760799886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 POYDRAS ST STE 1770",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701125204",
            "telephone_number": "727-834-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 STUBBS AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015628",
            "telephone_number": "727-834-0034",
            "fax_number": "318-323-8757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1645 Palm Beach Lakes Blvd Ste 1200",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334012214",
            "country_code": "US",
            "telephone_number": "727-834-0034",
            "fax_number": "727-609-6262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1340 Poydras St Ste 1770",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701125204",
            "country_code": "US",
            "telephone_number": "727-834-0034",
            "fax_number": "727-609-6262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEGURA HERNANDEZ",
        "first_name": "GUSTAVO",
        "name_prefix": "Dr.",
        "credential": "PHD, MP, ABPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-10",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY9350",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9350",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "LA",
            "license": "334132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.