Active NPI
Jessica Angela Marengo, MPSY, CPF
- Counseling Psychologist
- Carolina, PR
National Provider Identifier
1770808776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 3423
- Practice address
- 23-7 Ave Roberto Clemente
Villa Carolina
Carolina, PR 00985-5413 - Phone
- (939) 639-2629
- NPI assigned
- Apr 1, 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 | 3423 | PR | Primary |
Addresses
Primary practice location
23-7 Ave Roberto Clemente
Villa Carolina
Carolina, PR 00985-5413
Mailing address
Urb. Alturas de Interamericana #R-1 Calle 12
Trujillo Alto, PR 00976-3210
Phone (787) 459-0735
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3423 | PR | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270080000000",
"number": "1770808776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB. ALTURAS DE INTERAMERICANA #R-1 CALLE 12",
"city": "TRUJILLO ALTO",
"state": "PR",
"postal_code": "009763210",
"telephone_number": "787-459-0735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23-7 AVE ROBERTO CLEMENTE",
"address_2": "VILLA CAROLINA",
"city": "CAROLINA",
"state": "PR",
"postal_code": "009855413",
"telephone_number": "939-639-2629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARENGO",
"first_name": "JESSICA",
"middle_name": "ANGELA",
"name_prefix": "Mrs.",
"credential": "MPSY, CPF",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-01",
"last_updated": "2010-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PR",
"license": "3423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.