Active NPI
Michelle A Emick, PH.D.
- Clinical Neuropsychologist
- Denton, TX
National Provider Identifier
1063596005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 30727
- Practice address
- 1332 Teasley LN
Ste 177
Denton, TX 76205-7946 - Phone
- (940) 591-9550
- Fax
- (940) 591-9555
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 30727 | TX | Primary |
| Clinical Psychologist | 103TC0700X | 30727 | TX |
Addresses
Primary practice location
1332 Teasley LN
Ste 177
Denton, TX 76205-7946
Mailing address
PO Box 2852
Denton, TX 76202-2852
Phone (940) 591-9550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040685202 | Medicaid | TX |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111116000939 | TX | Practitioner - Clinical Psychologist | 0143494757 | Practice locations: Denton, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1332 Teasley LN
Suite 177
Denton, TX 76205-7946
Phone (940) 591-9550
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596412800000",
"number": "1063596005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2852",
"city": "DENTON",
"state": "TX",
"postal_code": "762022852",
"telephone_number": "940-591-9550",
"fax_number": "940-591-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1332 TEASLEY LN",
"address_2": "STE 177",
"city": "DENTON",
"state": "TX",
"postal_code": "762057946",
"telephone_number": "940-591-9550",
"fax_number": "940-591-9555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMICK",
"first_name": "MICHELLE",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2020-08-03",
"certification_date": "2020-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TX",
"license": "30727",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "30727",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "040685202",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.