Kimberly Marie Medina, MSC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

7716 Issued in PR

Practice address

PR 1 Ave. Sakura, Bairoa, Villa Blanca Industrial Park
Segundo Piso Suite 235
Caguas, PR 00725

Phone

(787) 705-5565

NPI assigned

Aug 29, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Psy-Q Kids Inc

  • Clinical Child & Adolescent Psychologist
  • Caguas, PR
  • NPI 1669210027
  NPD

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1932984804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 536",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007260536",
            "telephone_number": "787-705-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PR 1 AVE. SAKURA, BAIROA, VILLA BLANCA INDUSTRIAL PARK",
            "address_2": "SEGUNDO PISO SUITE 235",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-705-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "7716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adyanis Kamyl Medina Rodriguez, RN
• Ingrid Medina Vazquez, PHARM.D.
• Agustin Medina-Rosario, M.D.
• Eily Medina
• Keishla Medina, MPHE
• Mediquip Services Corp
• Mediquip Services Corp.
• Medtech Caribbean Inc.
• Naomi Mejias Roman
• Mejorarte LLC

• Counseling Psychologist in Caguas, PR
• Providers in Caguas, PR by specialty
• Counseling Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.