Charles Clifford Borsellino, PH.D.,PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

33874 Issued in TX

Practice address

628 Forest TRL
Argyle, TX 76226-6705

Phone

(817) 966-3910

NPI assigned

Oct 2, 2008

Last updated

Sep 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crossroads Counseling

  • Clinical Psychologist
  • Argyle, TX
  • NPI 1437785011
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1093966541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 FOREST TRL",
            "city": "ARGYLE",
            "state": "TX",
            "postal_code": "762266705",
            "telephone_number": "817-966-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 FOREST TRL",
            "city": "ARGYLE",
            "state": "TX",
            "postal_code": "762266705",
            "telephone_number": "817-966-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORSELLINO",
        "first_name": "CHARLES",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "credential": "PH.D.,PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-02",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "33874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Base Physical Therapy and Wellness
• Rebecca Marion Bass, RD, LD
• Mikala Becherer
• Kylie Belville, M.S.C., CNS-C
• Danielle Benito, LM
• Yvonne M Brannigan, PT, LMT
• Robin Luan Braughler
• Andrea Leigh Braziel, OTR
• Hannah Brewer
• Jennifer Brewton, RDN, LD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.

Verify at the official NPI Registry.