Individual provider Active NPI

Virmarie Correa Fernandez, PH.D.

  • Clinical Psychologist
  • San Juan, PR
National Provider Identifier
1881858645
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2243 Issued in PR
Practice address
Asociacion Servicios Salud Mental Y Contra la Adiccion
Programa Sera
San Juan, PR 00936
Phone
(787) 763-7575
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2243 PR Primary

Addresses

Primary practice location

Asociacion Servicios Salud Mental Y Contra la Adiccion
Programa Sera
San Juan, PR 00936

Mailing address

75 Bosque del Rio Walk Ups
Trujillo Alto, PR 00976-3152
Phone (787) 235-0496

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2243PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Support Services, Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1881858645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BOSQUE DEL RIO WALK UPS",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009763152",
            "telephone_number": "787-235-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ASOCIACION SERVICIOS SALUD MENTAL Y CONTRA LA ADICCION",
            "address_2": "PROGRAMA SERA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00936",
            "telephone_number": "787-763-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA FERNANDEZ",
        "first_name": "VIRMARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.