Individual provider Active NPI

Alexandra Pillat

  • Psychologist
  • Dallas, TX
National Provider Identifier
1104597699
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
40134 Issued in TX
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

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
PSY004482GAMDPsychologist
40134TXMDPsychologist
530457WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dowd Center for Child Development CurrentSince Dec 26, 2021 Accepting new patients
One Life Child Development Center, PLLC CurrentSince Feb 23, 2025 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.

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.

Verify at the official NPI Registry.