Madre Bay Consulting and Psychological Services, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

07392 Issued in TX

Legal business name

MADRE BAY CONSULTING AND PSYCHOLOGICAL SERVICES, PLLC

Practice address

215 E Queen Isabella Blvd Ste 102B
Port Isabel, TX 78578-2434

Phone

(956) 299-6107

Fax

(956) 299-6107

NPI assigned

Jun 30, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Marsha N Sargeant, PHDNPI 1093123960

Title

Owner

Phone

(956) 299-6107

Specialties & licenses 4

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marsha Nneka Sargeant, PH.D.

  • Psychologist
  • Port Isabel, TX
  • NPI 1093123960
  NPD (past) Authorized official

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498780800000",
    "number": "1114448925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 N SHORE DR",
            "city": "PORT ISABEL",
            "state": "TX",
            "postal_code": "785784633",
            "telephone_number": "956-299-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E QUEEN ISABELLA BLVD STE 102B",
            "city": "PORT ISABEL",
            "state": "TX",
            "postal_code": "785782434",
            "telephone_number": "956-299-6107",
            "fax_number": "956-299-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADRE BAY CONSULTING AND PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-30",
        "last_updated": "2017-06-30",
        "status": "A",
        "authorized_official_last_name": "SARGEANT",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-299-6107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "07392",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "07392",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "TX",
            "license": "07392",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "07392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362234201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01804306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Port Isabel, TX
• Providers in Port Isabel, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; 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.