East Texas Psychological Services, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

26853 Issued in TX

Legal business name

EAST TEXAS PSYCHOLOGICAL SERVICES, PLLC

Practice address

700 S Palestine St
Athens, TX 75751-3325

Phone

(903) 675-9570

Fax

(903) 675-9577

NPI assigned

Aug 3, 2010

Last updated

Aug 3, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William A McBride, PHDNPI 1477581700

Title

Owner

Phone

(903) 675-9570

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

East Texas Psychological Services PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Etpns

  • Clinical Psychologist
  • Athens, TX
  • NPI 1588846034
  NPD tax ID

Locations

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William A McBride, PHD

  • Clinical Psychologist
  • Athens, TX
  • NPI 1477581700
  Medicare reassignment Care Compare group NPD Authorized official
• Deena Rae Davis, MA, LPC

  • Professional Counselor
  • Kerens, TX
  • NPI 1750555876
  Medicare reassignment Care Compare group NPD
• Andrea Ellison, LCSW

  • Clinical Social Worker
  • Athens, TX
  • NPI 1093402380
  Medicare reassignment Care Compare group NPD
• Dawn Marie Lowe, PHD

  • Clinical Psychologist
  • Athens, TX
  • NPI 1831797794
  Medicare reassignment Care Compare group NPD
• Kathy Lynn McLelland, M.S., LPC

  • Professional Counselor
  • Emory, TX
  • NPI 1649325424
  Medicare reassignment Care Compare group NPD
• Lynn H Negrete, LPC

  • Professional Counselor
  • Athens, TX
  • NPI 1184847782
  Medicare reassignment Care Compare group NPD
• Robert Craig Nicks, PHD

  • Psychologist
  • Athens, TX
  • NPI 1053931014
  Medicare reassignment Care Compare group NPD
• William Arthur Pace, L.P.C.

  • Mental Health Counselor
  • Tyler, TX
  • NPI 1326332685
  Medicare reassignment Care Compare group NPD
• Curtis Ray Pickle, LPC

  • Professional Counselor
  • Athens, TX
  • NPI 1477059673
  Medicare reassignment Care Compare group NPD
• Diane Marilee Gard, PHD

  • Clinical Psychologist
  • Gun Barrel City, TX
  • NPI 1831264274
  NPD (past)
• Richard William Lawrence, LCSW

  • Clinical Social Worker
  • Tyler, TX
  • NPI 1326338807
  NPD (past)
• Rebecca Faith Robinson, LCSW

  • Clinical Social Worker
  • Paris, TX
  • NPI 1942238316
  NPD (past)

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280793600000",
    "number": "1093029951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S PALESTINE ST",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757513325",
            "telephone_number": "903-675-9570",
            "fax_number": "903-675-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PALESTINE ST",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757513325",
            "telephone_number": "903-675-9570",
            "fax_number": "903-675-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-03",
        "last_updated": "2010-08-03",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-675-9570",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "26853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Texas Medical Center Athens
• East Texas Medical Center Healthcare Associates (First Physicians)
• East Texas Medical Center Home Services (ETMC Home Health - West)
• East Texas Medical Imaging
• East Texas Pathology Laboratories
• East Texas Radiological Consultants P a
• Eastern Texas Pathology Laboratories, LLC
• Terri Lynn Eckert, M.D.
• Jonathan D Edwards, M.D.
• Mark L Eldore, M.D.

• Clinical Psychologist in Athens, TX
• Providers in Athens, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.