Individual provider Active NPI

Maria Pasqualetti, PSY.D.

  • Clinical Psychologist
  • Austin, TX
National Provider Identifier
1043522733
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3-6773 Issued in TX
Practice address
2222 Western Trails Blvd Ste 202
Austin, TX 78745-1647
Phone
(512) 448-3221
Fax
(512) 448-3218
NPI assigned
Jul 9, 2010
Last updated
Feb 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3-6773 TX Primary
Forensic Psychologist 103TF0200X 3-6773 TX

Addresses

Primary practice location

2222 Western Trails Blvd Ste 202
Austin, TX 78745-1647

Mailing address

2222 Western Trails Blvd Ste 202
Austin, TX 78745-1647
Phone (512) 448-3221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241122003844 TX Practitioner - Clinical Psychologist 7618402918 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3-6773TXMDForensic Psychologist
36773TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Spraggins Psychological Services, PLLC Clinical CurrentSince Oct 4, 2024 Accepting new patients

Locations

2222 Western Trails Blvd
Ste 202
Austin, TX 78745
Phone (512) 448-3221

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1043522733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 WESTERN TRAILS BLVD STE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451647",
            "telephone_number": "512-448-3221",
            "fax_number": "512-448-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 WESTERN TRAILS BLVD STE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451647",
            "telephone_number": "512-448-3221",
            "fax_number": "512-448-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASQUALETTI",
        "first_name": "MARIA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "3-6773",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "TX",
            "license": "3-6773",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.