Active NPI
Coralis D Arroyo Roman
- Clinical Child & Adolescent Psychologist
- Mayaguez, PR
National Provider Identifier
1851044457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 6612
- 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, 2023
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 6612 | PR | MD | Addiction (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.