Provider Demographics
NPI:1699590208
Name:MARIEL ADORNO PSYCHOLOGICAL & PROFESSIONAL GROUP, CSP
Entity type:Organization
Organization Name:MARIEL ADORNO PSYCHOLOGICAL & PROFESSIONAL GROUP, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADORNO DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:787-956-0062
Mailing Address - Street 1:PO BOX 1608
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-1608
Mailing Address - Country:US
Mailing Address - Phone:787-214-9887
Mailing Address - Fax:
Practice Address - Street 1:CARR 10 R651 KM 2.4
Practice Address - Street 2:SEC EL JUNCO BO. JUNCOS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-0000
Practice Address - Country:US
Practice Address - Phone:787-956-0062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty