Provider Demographics
NPI:1194519520
Name:CLINICA DE SERVICIOS PSICOLOGICOS SERENIDAD LLC
Entity type:Organization
Organization Name:CLINICA DE SERVICIOS PSICOLOGICOS SERENIDAD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SOTO MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-974-3773
Mailing Address - Street 1:2429 CALLE TURIN
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2221
Mailing Address - Country:US
Mailing Address - Phone:787-974-3773
Mailing Address - Fax:
Practice Address - Street 1:22 CALLE SOL STE 101
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-3820
Practice Address - Country:US
Practice Address - Phone:787-974-3773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty