Healthcare Provider Details

I. General information

NPI: 1821236670
Provider Name (Legal Business Name): PSYCHOLOGICAL CONSULTING SERVICE PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2009
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 CALLE MEDITERRANEO PASEO LOS CORALES II
DORADO PR
00646-9998
US

IV. Provider business mailing address

#715 CALLE MEDITERRANEO URB. PASEO LOS CORALES II
DORADO PR
00646
US

V. Phone/Fax

Practice location:
  • Phone: 787-395-7068
  • Fax:
Mailing address:
  • Phone: 787-395-7068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ADALEE SILVA
Title or Position: PRESIDENT
Credential: PSY.D
Phone: 787-395-7068