Healthcare Provider Details

I. General information

NPI: 1326841651
Provider Name (Legal Business Name): MINDSET PSYCHOLOGICAL & CONSULTANT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GALERIA PROFESIONAL 8118 CALLE CONCORDIA SUITE 102
PONCE PR
00717-1589
US

IV. Provider business mailing address

VISTAS DEL MAR 3310 CALLE DORADO
PONCE PR
00716-0827
US

V. Phone/Fax

Practice location:
  • Phone: 939-835-7257
  • Fax:
Mailing address:
  • Phone: 939-835-7257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MARILIA PADUA QUILES
Title or Position: PRESIDENT / OWNER
Credential: PSYD
Phone: 939-835-7257