| NPI | 1063530301 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2007-03-26 |
| Last Updated | 2010-07-21 |
| Authorized Official | Jesse Ingram Licensed Psyhologist CEO Phone: 2143392047 |
| Mailing Address | 5201 S Westmoreland Rd Dallas, TX 75237-1622 United States Phone: (214) 339-2047 | Fax: (214) 339-2049 📍 View Map |
| Primary Practice Address | 5201 S Westmoreland Rd Dallas, TX 75237-1622 United States Phone: (214) 339-2047 | Fax: (214) 339-2049 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | TX | 034167901 | — |
| Other (non-Medicare) | TX | 81678P | BCBS # |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 103TB0200X – Psychologist, Cognitive & Behavioral | TX | 2-3078 |
| No | 103TC0700X – Psychologist, Clinical | TX | 2-3078 |
| No | 103TC1900X – Psychologist, Counseling | TX | 2-3078 |
| No | 103TR0400X – Psychologist, Rehabilitation | TX | 2-3078 |
| Yes | 103T00000X – Psychologist | TX | 2-3078 |
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About NPI 1063530301
Behavioral Psychology Clinic, Pc is an organization registered in the CMS NPPES NPI Registry with NPI number 1063530301. The primary specialty listed is Psychologist. The organization is located in Dallas, TX. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-03-26. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1063530301?
NPI 1063530301 belongs to Behavioral Psychology Clinic, Pc, a Psychologist in Dallas, TX. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1063530301 active?
The current status of NPI 1063530301 in the NPPES registry is Active. The record was last updated on 2010-07-21.
What specialty is NPI 1063530301?
NPI 1063530301 is classified under the taxonomy Psychologist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1063530301?
You can verify NPI 1063530301 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1063530301?
The primary practice address on file for NPI 1063530301 is 5201 S Westmoreland Rd, Dallas, TX 75237-1622. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1063530301 issued?
NPI 1063530301 was first issued (enumerated) on 2007-03-26. The NPPES record was last updated on 2010-07-21.
Practice Location Map
Behavioral Psychology Clinic, Pc is located at 5201 S Westmoreland Rd, Dallas, TX. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Behavioral Psychology Clinic, Pc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1063530301. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Psychologist, Cognitive & Behavioral | 2-3078 | TX |
| Psychologist, Clinical | 2-3078 | TX |
| Psychologist, Counseling | 2-3078 | TX |
| Psychologist, Rehabilitation | 2-3078 | TX |
| Psychologist | 2-3078 | TX |