NPIMap

Individual provider Active NPI

M Teresa Nezworski, PHD

  • Clinical Psychologist
  • El Paso, TX
National Provider Identifier
1013125376
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
24487 Issued in TX
Practice address
300 Skyview, # H8
El Paso, TX 79912-3134
Phone
(915) 244-7764
NPI assigned
May 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 24487 TX
Cognitive & Behavioral Psychologist 103TB0200X 24487 TX
Clinical Psychologist 103TC0700X 24487 TX Primary
Clinical Child & Adolescent Psychologist 103TC2200X 24487 TX
Health Psychologist 103TH0004X 24487 TX
Health Service Psychologist 103TH0100X 24487 TX
Intellectual & Developmental Disabilities Psychologist 103TM1800X 24487 TX
Group Psychotherapy Psychologist 103TP2701X 24487 TX
School Psychologist 103TS0200X 6535 TX

Addresses

Primary practice location

300 Skyview, # H8
El Paso, TX 79912-3134

Mailing address

300 Skyview, # H8
El Paso, TX 79912-3134
Phone (915) 244-7764

Other names 1

  • Dr. Mary Teresa Nezworski Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6535TXMDSchool Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1013125376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SKYVIEW, # H8",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799123134",
            "telephone_number": "915-244-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SKYVIEW, # H8",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799123134",
            "telephone_number": "915-244-7764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEZWORSKI",
        "first_name": "M TERESA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-19",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "24487",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "TX",
            "license": "24487",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "24487",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TX",
            "license": "24487",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "TX",
            "license": "24487",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "TX",
            "license": "24487",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "TX",
            "license": "24487",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "TX",
            "license": "24487",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "TX",
            "license": "6535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY TERESA",
            "last_name": "NEZWORSKI",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.