Angelique Trask-Tate, PH.D., LSSP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

36431 Issued in TX

Practice address

9700 Bissonnet St Ste 1000W
Houston, TX 77036-8001

Phone

(504) 236-8096

NPI assigned

Sep 8, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment NPD

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1053712232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 BISSONNET ST STE 1000W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770368001",
            "telephone_number": "504-236-8096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 BISSONNET ST STE 1000W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770368001",
            "telephone_number": "504-236-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRASK-TATE",
        "first_name": "ANGELIQUE",
        "credential": "PH.D., LSSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "TX",
            "license": "36431",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "36431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NOT APPLICABLE",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Houston, TX
• Providers in Houston, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.