Healthcare Provider Details

I. General information

NPI: 1184832669
Provider Name (Legal Business Name): CESA- ACCESA CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 ST, C- 21, OF 3 FOREST HILLS
BAYAMON PR
00956
US

IV. Provider business mailing address

151 CALLE ZIRCONIA PRADOS DORADO SUR
DORADO PR
00646-9654
US

V. Phone/Fax

Practice location:
  • Phone: 787-796-5654
  • Fax:
Mailing address:
  • Phone: 787-796-5654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0016
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number0016
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0016
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0016
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0016
License Number StatePR
# 6
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0016
License Number StatePR
# 7
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number0016
License Number StatePR
# 8
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number0016
License Number StatePR

VIII. Authorized Official

Name: DR. CARLOS DAVID COSTA
Title or Position: PRESIDENT & FOUNDER
Credential: DD,MA,MHS, MAC, LSAC
Phone: 787-241-9660