Provider Demographics
NPI:1831075886
Name:MENTAL
Entity type:Organization
Organization Name:MENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:C
Authorized Official - Last Name:MRAIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-646-5505
Mailing Address - Street 1:1790 CALLE JULIO AYBAR
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4410
Mailing Address - Country:US
Mailing Address - Phone:787-646-5505
Mailing Address - Fax:
Practice Address - Street 1:800 CALLE HIPODROMO STE 102
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2504
Practice Address - Country:US
Practice Address - Phone:787-646-5505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty