NPIMap

Organization Active NPI

Psicologia Integral Clinica Forense Dra. Norma Gomez Soto CSP

  • Clinical Psychologist
  • Arecibo, PR
National Provider Identifier
1821458449
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PSICOLOGIA INTEGRAL CLINICA FORENSE DRA. NORMA GOMEZ SOTO CSP
Practice address
416 Avenida Jose Celso Balbosa
Bajos
Arecibo, PR 00612
Phone
(787) 879-1962
NPI assigned
Feb 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Authorized official

Name
Dr. Norma Gomez Soto, DRA.
Title
Dra./Presidenta
Phone
(787) 479-6244

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X

Addresses

Primary practice location

416 Avenida Jose Celso Balbosa
Bajos
Arecibo, PR 00612

Mailing address

PO Box 433
Avenida Jose Celso Balbosa 416 Bajos
Arecibo, PR 00613-0433
Phone (787) 879-1962

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180220001034 PR Part B Supplier - Clinic/Group Practice 3375804156 Receives reassigned benefits from 1 practitioner
Practice locations: Arecibo, PR

National Provider Directory

National Provider Directory

Locations

418 Ave Barbosa
Arecibo, PR 00612
Phone (787) 879-1962

Practitioners & affiliated clinicians

Practitioners 9

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": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1821458449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 433",
            "address_2": "AVENIDA JOSE CELSO BALBOSA 416 BAJOS",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006130433",
            "telephone_number": "787-879-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 AVENIDA JOSE CELSO BALBOSA",
            "address_2": "BAJOS",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-879-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSICOLOGIA INTEGRAL CLINICA FORENSE DRA. NORMA GOMEZ SOTO CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "GOMEZ SOTO",
        "authorized_official_first_name": "NORMA",
        "authorized_official_title_or_position": "DRA./PRESIDENTA",
        "authorized_official_telephone_number": "787-479-6244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DRA."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.