Keishla M Esparra Lugo, MA

Individual provider Active NPI Counseling Psychologist · Comerio, PR

NPI 1972089290 · NPPES record last updated Dec 17, 2022

Key facts

NPI
1972089290
Entity type
Individual (NPI type 1)
Primary specialty
Counseling Psychologist 103TC1900X
License
6161 (PR)
Practice address
5 Calle Santiago Palmer
Comerio, PR 00782
Phone
(787) 702-6452
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210104000788 PR Practitioner - Clinical Psychologist 4880007293 Practice locations: Cidra, PR; Comerio, PR

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Arts, Doctor of Philosophy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist
Group: 193400000X SINGLE SPECIALTY GROUP
103TA0400X
Counseling Psychologist 103TC1900X 6161 PR Yes

Addresses

Primary practice location

5 Calle Santiago Palmer
Comerio, PR 00782

Mailing address

HC 4 Box 8332
Comerio, PR 00782-9506
Phone (787) 702-6452

Other identifiers

IdentifierTypeStateIssuer
6161OtherPRPSICOLOGA

Other providers in Comerio, PR

All providers in Comerio, PR · Counseling Psychologist in Puerto Rico

Sources for this page

Verify at the official NPI Registry.