Individual provider Active NPI

Fatima Afsheen Shaik, PSYD

  • Clinical Psychologist
  • Dallas, TX
National Provider Identifier
1053893420
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
39982 Issued in TX
Practice address
8140 Walnut Hill LN Ste 440
Dallas, TX 75231-4396
Phone
(469) 709-9250
Fax
(214) 594-8332
NPI assigned
Sep 3, 2018
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 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 39982 TX Primary

Addresses

Primary practice location

8140 Walnut Hill LN Ste 440
Dallas, TX 75231-4396

Mailing address

8140 Walnut Hill LN Ste 440
Dallas, TX 75231-4396
Phone (469) 709-9250

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

State licenses

LicenseStateTypeSpecialty
39982TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Therapy Collective, PLLC Past Accepting new patients

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": "1535932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1053893420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 WALNUT HILL LN STE 440",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314396",
            "telephone_number": "469-709-9250",
            "fax_number": "214-594-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 WALNUT HILL LN STE 440",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314396",
            "telephone_number": "469-709-9250",
            "fax_number": "214-594-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIK",
        "first_name": "FATIMA",
        "middle_name": "AFSHEEN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-03",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "39982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.