NPIMap

Organization Active NPI

Mindful Healing Psychotherapy Clinic

  • Clinical Psychologist
  • Aguada, PR
National Provider Identifier
1801656020
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MINDFUL HEALING PSYCHOTHERAPY CLINIC
Practice address
Aguada Complex Suite 5
Carretera 115
Aguada, PR 00602
Phone
(787) 487-9086
NPI assigned
Mar 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Authorized official

Name
Ana Concepcion Carrero, DRANPI 1740592542
Title
Pscology
Phone
(787) 487-9086

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

Aguada Complex Suite 5
Carretera 115
Aguada, PR 00602

Mailing address

Urb Flamboyanes 39
Aguada, PR 00602
Phone (787) 487-9086

Other names 1

  • Mindful Healing Psychotherapy Clinic Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240928000121 PR Part B Supplier - Clinic/Group Practice 2668903857 Receives reassigned benefits from 4 practitioners
Practice locations: Aguada, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1801656020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB FLAMBOYANES 39",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "00602",
            "telephone_number": "787-487-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AGUADA COMPLEX SUITE 5",
            "address_2": "CARRETERA 115",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "00602",
            "telephone_number": "787-487-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL HEALING PSYCHOTHERAPY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "CONCEPCION CARRERO",
        "authorized_official_first_name": "ANA",
        "authorized_official_title_or_position": "PSCOLOGY",
        "authorized_official_telephone_number": "787-487-9086",
        "authorized_official_credential": "DRA"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Healing Psychotherapy Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Aguada, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.