Provider Demographics
NPI:1063390029
Name:PSICO GROUP DE PR INC
Entity type:Organization
Organization Name:PSICO GROUP DE PR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSICOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:R
Authorized Official - Last Name:ANDINO SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:MPSY
Authorized Official - Phone:787-220-1272
Mailing Address - Street 1:PO BOX 604
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-0604
Mailing Address - Country:US
Mailing Address - Phone:787-220-1272
Mailing Address - Fax:
Practice Address - Street 1:CONCORDIA SHOPPING CENTER
Practice Address - Street 2:AVE. 65TH INFANTERIA BO. SABANA LLANA SUR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00729-0604
Practice Address - Country:US
Practice Address - Phone:787-220-1272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty