Ednaliz Camacho Montes – Psychologist in Arroyo, PR

Key facts

NPI: 1811487531
Entity type: Individual (NPI type 1)
Primary specialty: Psychologist 103T00000X
License: 5646 (PR)
Practice address: Urb Brisas del Mar
14 Calle Isaac
Arroyo, PR 00714
Phone: (787) 597-7967
NPI assigned: May 17, 2018
Sex: Female
Sole proprietor: No

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.

Clinica Psicologica del Sureste LLC Mental Health Clinic/Center (Including Community Mental Health Center) · Guayama, PR · NPI 1619821949

NPD

Medicare Care Compare profile

Specialty: Clinical Psychologist
Education: Other, 2014
Medicare assignment: Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5015 Calle Punta Tuna
Maunabo, PR 00707

Calle Duque 29 Esquina San Jose
Guayama, PR 00784
Phone (939) 335-0868

Medicare participation

Medicare fee-for-service enrollment: Enrolled in PR

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20260623001493	PR	Practitioner - Psychologist Billing Independently	1052884962	Practice locations: Guayama, PR

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Clinica Psicologica del Sureste LLC		Current	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Psychologist	103T00000X	5646	PR	Yes

Addresses

Primary practice location

Urb Brisas del Mar
14 Calle Isaac
Arroyo, PR 00714

Mailing address

Urb Brisas del Mar
14 Calle Isaac
Arroyo, PR 00714
Phone (787) 597-7967

Other providers in Arroyo, PR

All providers in Arroyo, PR · 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 May 17, 2018. 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.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.