| Plenitud Psicoterapia Y Autocuidado Llc | |
|
Calle Severo Arana #21 Suite B San Sebastian PR 00685 | |
| (787) 896-1313 | |
| Not Available |
| Full Name | Plenitud Psicoterapia Y Autocuidado Llc |
|---|---|
| Speciality | Psychologist |
| Location | Calle Severo Arana #21 Suite B, San Sebastian, Puerto Rico |
| Authorized Official Name and Position | Omar Anibal Fuentes Flores (SOCIAL WORKER) |
| Authorized Official Contact | 9396402984 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Plenitud Psicoterapia Y Autocuidado Llc Calle Severo Arana #21 Suite B San Sebastian PR 00685 Ph: (787) 896-1313 | Plenitud Psicoterapia Y Autocuidado Llc Calle Severo Arana #21 Suite B San Sebastian PR 00685 Ph: (787) 896-1313 |
| NPI Number | 1770365561 |
|---|---|
| Provider Enumeration Date | 10/17/2023 |
| Last Update Date | 10/17/2023 |
| Certification Date | 10/16/2023 |
| Medicare PECOS PAC ID | 7012452204 |
|---|---|
| Medicare Enrollment ID | O20240711003543 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770365561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lissette Guzman Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720274491 PECOS PAC ID: 9032507876 Enrollment ID: I20211027000785 |
| Provider Name | Lissette Guzman Perez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720274491 PECOS PAC ID: 9032507876 Enrollment ID: I20240823004008 |
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