Individual provider Active NPI

Anita Luisa Sohn McCormick, PH.D.

  • Psychologist
  • Bryan, TX
National Provider Identifier
1073809315
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35194 Issued in TX
Practice address
1318 Memorial Dr
Bryan, TX 77802-5215
Phone
(979) 776-2872
Fax
(979) 776-2872
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35194 TX Primary

Addresses

Primary practice location

1318 Memorial Dr
Bryan, TX 77802-5215

Mailing address

1318 Memorial Dr
Bryan, TX 77802-5215
Phone (979) 776-2872

Other names 1

  • Miss Anita Luisa Sohn Former name

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
35194TXMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1073809315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 MEMORIAL DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025215",
            "telephone_number": "979-776-2872",
            "fax_number": "979-776-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 MEMORIAL DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025215",
            "telephone_number": "979-776-2872",
            "fax_number": "979-776-2872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOHN MCCORMICK",
        "first_name": "ANITA",
        "middle_name": "LUISA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "35194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANITA",
            "last_name": "SOHN",
            "middle_name": "LUISA",
            "prefix": "MISS",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.