NPIMap

Organization Active NPI

PF Dover Counseling

  • Clinical Psychologist
  • Southlake, TX
National Provider Identifier
1043563877
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
69365 Issued in TX
Legal business name
PF DOVER COUNSELING
Practice address
515 W Southlake Blvd
Suite Number 172
Southlake, TX 76092-6172
Phone
(309) 363-2544
NPI assigned
Oct 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Authorized official

Name
Scott Smith
Title
Owner
Phone
(309) 363-2544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 69365 TX Primary

Addresses

Primary practice location

515 W Southlake Blvd
Suite Number 172
Southlake, TX 76092-6172

Mailing address

515 W Southlake Blvd
Ste 172
Southlake, TX 76092-6172

National Provider Directory

National Provider Directory
Tax ID family
PF Dover Counseling2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1043563877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W SOUTHLAKE BLVD",
            "address_2": "STE 172",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W SOUTHLAKE BLVD",
            "address_2": "SUITE NUMBER 172",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926172",
            "telephone_number": "309-363-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PF DOVER COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-363-2544"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "69365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.