MEDICARE: CENTRO DE SERVICIOS PSICOLOGICOS THERAPSIS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1558207886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRO DE SERVICIOS PSICOLOGICOS THERAPSIS LLC

Provider Business Mailing Address
First Line	:	PO BOX 580
Second Line	:
City	:	GARROCHALES
State	:	PR
Zip	:	00652-0580
Country	:	US
Telephone Number	:	787-452-9214
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 AVE ROTARIOS
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00612
Country	:	US
Telephone Number	:	939-247-3843
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	OLGA I CRUZ ROMAN
Credential	:
Telephone Number	:	787-452-9214

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	04/28/2026

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