Individual provider Active NPI

Coralis D Arroyo Roman

  • Clinical Child & Adolescent Psychologist
  • Mayaguez, PR
National Provider Identifier
1851044457
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
6612 Issued in PR
Practice address
Carretera #2 Kilometro 156.5
Medical Emporium L Suite #203
Mayaguez, PR 00680
Phone
(787) 376-7589
NPI assigned
Feb 2, 2022
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 6612 PR
Clinical Psychologist 103TC0700X 6612 PR
Counseling Psychologist 103TC1900X 6612 PR
Clinical Child & Adolescent Psychologist 103TC2200X 6612 PR Primary
Family Psychologist 103TF0000X 6612 PR
Group Psychotherapy Psychologist 103TP2701X 6612 PR
Psychoanalyst 102L00000X 6612 PR

Addresses

Primary practice location

Carretera #2 Kilometro 156.5
Medical Emporium L Suite #203
Mayaguez, PR 00680

Mailing address

PO Box 771
Aguada, PR 00602-0771
Phone (787) 963-7070

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

LicenseStateTypeSpecialty
6612PRMDAddiction (Substance Use Disorder) Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1851044457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 771",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006020771",
            "telephone_number": "787-963-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA #2 KILOMETRO 156.5",
            "address_2": "MEDICAL EMPORIUM L SUITE #203",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-376-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARROYO ROMAN",
        "first_name": "CORALIS",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-02",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "PR",
            "license": "6612",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6612",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "6612",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PR",
            "license": "6612",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "PR",
            "license": "6612",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "PR",
            "license": "6612",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "PR",
            "license": "6612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.