Individual provider Active NPI

Claribel Medina Montano

  • Counseling Psychologist
  • Aguada, PR
National Provider Identifier
1912447764
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6510 Issued in PR
Practice address
165 Calle la Paz
Aguada, PR 00602-3206
Phone
(787) 868-3700
NPI assigned
Feb 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Counseling Psychologist 103TC1900X 6510 PR Primary

Addresses

Primary practice location

165 Calle la Paz
Aguada, PR 00602-3206

Mailing address

165 Calle la Paz
Aguada, PR 00602-3206
Phone (787) 868-3700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230712003538 PR Practitioner - Psychologist Billing Independently 9436519204 Practice locations: Aguada, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6510PRMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrisector LLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

165 Calle La Paz
Aguada, PR 00602
Phone (678) 890-7174

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": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1912447764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 CALLE LA PAZ",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006023206",
            "telephone_number": "787-868-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 CALLE LA PAZ",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006023206",
            "telephone_number": "787-868-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA MONTANO",
        "first_name": "CLARIBEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-27",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "6510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguada, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.