| Clinica Psicologica Las Mirlas Llc | |
|
64 Calle San Miguel Guanica PR 00653-2809 | |
| (787) 673-8394 | |
| Not Available |
| Full Name | Clinica Psicologica Las Mirlas Llc |
|---|---|
| Speciality | Psychologist |
| Location | 64 Calle San Miguel, Guanica, Puerto Rico |
| Authorized Official Name and Position | Gabriela Enid Luciano (DIRECTOR) |
| Authorized Official Contact | 7876738394 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Psicologica Las Mirlas Llc Po Box 939 Ensenada PR 00647-0939 Ph: (787) 673-8394 | Clinica Psicologica Las Mirlas Llc 64 Calle San Miguel Guanica PR 00653-2809 Ph: (787) 673-8394 |
| NPI Number | 1104485077 |
|---|---|
| Provider Enumeration Date | 06/13/2019 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/09/2024 |
| Medicare PECOS PAC ID | 0244679207 |
|---|---|
| Medicare Enrollment ID | O20240423004588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104485077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gabriela Enid Luciano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073025995 PECOS PAC ID: 7618238833 Enrollment ID: I20180305001874 |
| Provider Name | Samary Feliciano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285281915 PECOS PAC ID: 9537580436 Enrollment ID: I20200602000146 |
Migrant Health Center Western Region, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: Carretera 324 Km 2.1, Bo Ensenada El Batey, Guanica, PR 00647 Phone: 787-821-3377 Fax: 787-834-1924 |