Active NPI
Alexandra Pillat
- Psychologist
- Dallas, TX
National Provider Identifier
1104597699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 40134
- Practice address
- 4100 Spring Valley Rd Ste 930
Dallas, TX 75244-3755 - Phone
- (214) 536-6992
- NPI assigned
- Sep 23, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY004482 | GA | |
| Psychologist | 103T00000X | 40134 | TX | Primary |
| Psychologist | 103T00000X | 530457 | WI |
Addresses
Primary practice location
4100 Spring Valley Rd Ste 930
Dallas, TX 75244-3755
Mailing address
4100 Spring Valley Rd Ste 930
Dallas, TX 75244-3755
Phone (214) 536-6992
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | office |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY004482 | GA | MD | Psychologist |
| 40134 | TX | MD | Psychologist |
| 530457 | WI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dowd Center for Child Development | Current | Accepting new patients | |
| One Life Child Development Center, PLLC | Current | Accepting new patients |
Locations
945 Memorial Dr SE
Ste 422
Atlanta, GA 30316
Phone (404) 293-6947
4100 Spring Valley Rd
Ste 930
Dallas, TX 75244
Phone (214) 536-6992
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adolescent and Children Mental Health Clinic/Center
- Dallas, TX
- NPI 1285449843
-
- Adolescent and Children Mental Health Clinic/Center
- Atlanta, GA
- NPI 1770243438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738800000000",
"number": "1104597699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 SPRING VALLEY RD STE 930",
"city": "DALLAS",
"state": "TX",
"postal_code": "752443755",
"telephone_number": "214-536-6992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 SPRING VALLEY RD STE 930",
"city": "DALLAS",
"state": "TX",
"postal_code": "752443755",
"telephone_number": "214-536-6992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PILLAT",
"first_name": "ALEXANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-23",
"last_updated": "2025-02-06",
"certification_date": "2025-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "GA",
"license": "PSY004482",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "40134",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "530457",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "office",
"affiliation": "N",
"endpointDescription": "office",
"address_1": "945 Memorial Dr SE Ste 422",
"city": "Atlanta",
"state": "GA",
"country_code": "US",
"postal_code": "303161537",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.