Individual provider Active NPI

Nicole M Velez Agosto

  • Clinical Psychologist
  • McAllen, TX
National Provider Identifier
1043793052
Registry record updated Aug 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
38897 Issued in TX
Practice address
3508 Harvard Ave
McAllen, TX 78504-6638
Phone
(956) 560-0799
NPI assigned
Sep 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 38897 TX Primary

Addresses

Primary practice location

3508 Harvard Ave
McAllen, TX 78504-6638

Mailing address

3508 Harvard Ave
McAllen, TX 78504-6638
Phone (956) 530-2927

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
I20230615003554 TX Practitioner - Clinical Psychologist 3274991641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ourpsyche, Inc.Group PAC ID 2264865443, 3 clinicians

Practice addresses (Care Compare)

5311 S McColl Rd
Edinburg, TX 78539-9168
Phone (956) 322-8690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jun 5, 2023 Accepting new patients
Our Psyche, Inc CurrentSince Dec 17, 2024 Accepting new patients

Locations

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

2102 W Trenton Rd
Edinburg, TX 78539
Phone (956) 388-1300

5311 S McColl Rd
Edinburg, TX 78539
Phone (956) 322-8690

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1043793052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 HARVARD AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785046638",
            "telephone_number": "956-530-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 HARVARD AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785046638",
            "telephone_number": "956-560-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELEZ AGOSTO",
        "first_name": "NICOLE",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.