Healthcare Provider Details

I. General information

NPI: 1679230437
Provider Name (Legal Business Name): JESSICA MORALES ACEVEDO PSYD, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 CALLE LA PAZ CENTRO DE USOS MULTIPLES
AGUADA PR
00602-3228
US

IV. Provider business mailing address

HC 59 BOX 6714
AGUADA PR
00602-9639
US

V. Phone/Fax

Practice location:
  • Phone: 939-370-0728
  • Fax:
Mailing address:
  • Phone: 939-370-0728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7392
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11431
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: