Provider Demographics
NPI:1881897775
Name:SERVICIOS PSICOLOGICOS INTEGRALES
Entity type:Organization
Organization Name:SERVICIOS PSICOLOGICOS INTEGRALES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:SOCORRO
Authorized Official - Last Name:LASSUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-728-3800
Mailing Address - Street 1:SAN JORGE MEDICAL BUILDING
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00912
Mailing Address - Country:US
Mailing Address - Phone:787-728-3800
Mailing Address - Fax:787-728-3850
Practice Address - Street 1:SAN JORGE MEDICAL BUILDING
Practice Address - Street 2:SUITE 204
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-728-3800
Practice Address - Fax:787-728-3850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty