Individual provider Active NPI

Dale Chandes Godby, PHD

  • Clinical Psychologist
  • Dallas, TX
National Provider Identifier
1073633871
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
22348 Issued in TX
Practice address
6330 Lyndon B Johnson Fwy Ste 150
Dallas, TX 75240-6431
Phone
(972) 233-0648
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 22348 TX Primary

Addresses

Primary practice location

6330 Lyndon B Johnson Fwy Ste 150
Dallas, TX 75240-6431

Mailing address

6330 Lyndon B Johnson Fwy Ste 150
Dallas, TX 75240-6431
Phone (972) 233-0648

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
22348TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073633871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 LYNDON B JOHNSON FWY STE 150",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406431",
            "telephone_number": "972-233-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 LYNDON B JOHNSON FWY STE 150",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406431",
            "telephone_number": "972-233-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODBY",
        "first_name": "DALE",
        "middle_name": "CHANDES",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "22348",
            "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 Jul 8, 2007; 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.