Jeanne C. Selby, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

31083 Issued in TX

Practice address

2340 E Trinity Mills Rd
Suite 300
Carrollton, TX 75006-1942

Phone

(214) 762-8079

Fax

(972) 820-9711

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Jeanne E Costello Former name

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

University of North Texas HSC, College of Osteopathic Med, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Dallas Injections and Diagnostics

  • Health Service Clinic/Center
  • Dallas, TX
  • NPI 1154545838
  NPD (past)
• Deer Oaks Geriatric Services P C

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1134169287
  NPD (past)
• Psychology Associates of North Texas

  • Psychologist
  • Denton, TX
  • NPI 1306855549
  NPD (past)
• Psychology Associates of North Texas, P.a.

  • Psychologist
  • Denton, TX
  • NPI 1629147327

  Clinical

  NPD (past)
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1124051057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 WOODBURY",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750075279",
            "telephone_number": "214-762-8079",
            "fax_number": "972-820-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 E TRINITY MILLS RD",
            "address_2": "SUITE 300",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750061942",
            "telephone_number": "214-762-8079",
            "fax_number": "972-820-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELBY",
        "first_name": "JEANNE",
        "middle_name": "C.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "31083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7192856",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD (BCBS)",
            "identifier": "0072PQ",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK (MHN)",
            "identifier": "396566",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157554007",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNE",
            "last_name": "COSTELLO",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Princy Sebastian, MS
• Felix Segovia, MD
• Kurt Aiden Seidler, DDS
• Melissa Elizabeth Seiter, MS, LPC, LCDC
• Selah Home Healthcare Inc
• Select Operations of Carrollton LLC
• Rachel Lee Self, FNP-C
• April Dawn Sellers
• Sharlene Selvaratnam, M.D.
• Senior Care Transitions, LLC

• Clinical Psychologist in Carrollton, TX
• Providers in Carrollton, 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 9, 2008; 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.