MEDICARE: BEWELL PSYCHOLOGICAL SERVICES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1760018204
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEWELL PSYCHOLOGICAL SERVICES

Provider Business Mailing Address
First Line	:	CC10 CALLE DR JOSE SABATER
Second Line	:
City	:	TOA BAJA
State	:	PR
Zip	:	00949-3335
Country	:	US
Telephone Number	:	787-399-9438
Fax Number	:

Provider Business Practice Location Address
First Line	:	CC10 CALLE DR JOSE SABATER
Second Line	:
City	:	TOA BAJA
State	:	PR
Zip	:	00949-3335
Country	:	US
Telephone Number	:	787-399-9438
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	ORLANDO SANCHEZ
Credential	:	M.A.
Telephone Number	:	787-399-9438

Provider Enumeration Date	:	03/17/2020
Last Update Date	:	03/17/2020

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Directions to “BEWELL PSYCHOLOGICAL SERVICES ” Practice Location

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