Behavioral Psychology Clinic, PC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2-3078 Issued in TX

Legal business name

BEHAVIORAL PSYCHOLOGY CLINIC, PC

Practice address

5201 S Westmoreland Rd
Dallas, TX 75237-1622

Phone

(214) 339-2047

Fax

(214) 339-2049

NPI assigned

Mar 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jesse C Ingram, PH.D.

Title

Licensed Psyhologist Ceo

Phone

(214) 339-2047

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• The Rehab Group Other name

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1063530301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 S WESTMORELAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752371622",
            "telephone_number": "214-339-2047",
            "fax_number": "214-339-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 S WESTMORELAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752371622",
            "telephone_number": "214-339-2047",
            "fax_number": "214-339-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL PSYCHOLOGY CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "LICENSED PSYHOLOGIST CEO",
        "authorized_official_telephone_number": "214-339-2047",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "2-3078",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "TX",
            "license": "2-3078",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "2-3078",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "2-3078",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": "TX",
            "license": "2-3078",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034167901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "81678P",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Rehab Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Behavioral Health Connections, Inc.
• Behavioral Health Dallas, PLLC
• Behavioral Health Link Corporation
• Behavioral Health of North Texas LLP
• Behavioral Medicine Clinic
• Mohammad Rahim Behdar, DC
• Annahita Beheshti, DMSC, PA-C
• Sheila N Behimehr
• Soroush Behnam, MD
• Martin M Behnke, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.