Keishla M Esparra Lugo, MA

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

6161 Issued in PR

Practice address

5 Calle Santiago Palmer
Comerio, PR 00782

Phone

(787) 702-6452

NPI assigned

Jul 19, 2018

Last updated

Dec 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671235200000",
    "number": "1972089290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 4 BOX 8332",
            "city": "COMERIO",
            "state": "PR",
            "postal_code": "007829506",
            "telephone_number": "787-702-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CALLE SANTIAGO PALMER",
            "city": "COMERIO",
            "state": "PR",
            "postal_code": "00782",
            "telephone_number": "787-702-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPARRA LUGO",
        "first_name": "KEISHLA",
        "middle_name": "M",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2022-12-17",
        "certification_date": "2022-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "6161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSICOLOGA",
            "identifier": "6161",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Comerio, PR
• Providers in Comerio, 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 Dec 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.