Mimi H. Wright, PH.D., LP, LSSP

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

License

25128 Issued in TX

Practice address

201 Posey Ave
Clifton, TX 76634-1200

Phone

(254) 675-8621

Fax

(254) 675-2254

NPI assigned

Dec 27, 2010

Last updated

May 31, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bosque County Hospital DistrictGroup PAC ID 4587997754, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Bosque County Hospital District

  dba Goodall-Witcher Clinic in Whitney

  • Rural Health Clinic/Center
  • Whitney, TX
  • NPI 1720540255
  Medicare reassignment Care Compare group NPD
• Bosque County Hospital District

  dba Goodall-Witcher Hospital

  • Critical Access Hospital
  • Clifton, TX
  • NPI 1104383371
  NPD
• Bosque County Hospital District

  dba Goodall-Witcher Clinic in Clifton

  • Rural Health Clinic/Center
  • Clifton, TX
  • NPI 1841752375
  NPD (past)

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1114221611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 COUNTY ROAD 4145",
            "city": "CRANFILLS GAP",
            "state": "TX",
            "postal_code": "766374550",
            "telephone_number": "254-253-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 POSEY AVE",
            "city": "CLIFTON",
            "state": "TX",
            "postal_code": "766341200",
            "telephone_number": "254-675-8621",
            "fax_number": "254-675-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "MIMI",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP, LSSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-27",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "TX",
            "license": "25128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030182203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• West Wharton County Hospital District (Willow Park Rehabilitation and Healthcare Center)
• Chanel Janes Wilkinson, FNP, PMHNP
• Shelly Willeford, RPH
• Denise M Wise, LPT
• Sherri Word-Proffitt, R.PH.
• Angela Ann Zuehlke

• Health Service Psychologist in Clifton, TX
• Providers in Clifton, TX by specialty
• Health Service Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.