Active NPI
Colleen Jungersen, PHD
- Psychologist
- Katy, TX
National Provider Identifier
1114757697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 39997
- Practice address
- 3750 S Mason Rd
Katy, TX 77450-7721 - Phone
- (281) 962-6025
- NPI assigned
- Aug 7, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 39997 | TX | Primary |
Addresses
Primary practice location
3750 S Mason Rd
Katy, TX 77450-7721
Mailing address
26927 Sandy Arbor LN
Katy, TX 77494-2449
Phone (281) 415-5788
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39997 | TX | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Noa Developmental Services PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Katy, TX
- NPI 1093668006
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722988800000",
"number": "1114757697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26927 SANDY ARBOR LN",
"city": "KATY",
"state": "TX",
"postal_code": "774942449",
"telephone_number": "281-415-5788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3750 S MASON RD",
"city": "KATY",
"state": "TX",
"postal_code": "774507721",
"telephone_number": "281-962-6025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNGERSEN",
"first_name": "COLLEEN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-07",
"last_updated": "2024-08-07",
"certification_date": "2024-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "39997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.