Active NPI
Lisa Marie Collingwood, PHD
- Psychologist
- Dallas, TX
National Provider Identifier
1134158751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3031
- Practice address
- 8204 Elmbrook Dr
Suite 360
Dallas, TX 75247-4067 - Phone
- (214) 219-0780
- Fax
- (214) 219-0782
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 3031 | WI | Primary |
Addresses
Primary practice location
8204 Elmbrook Dr
Suite 360
Dallas, TX 75247-4067
Mailing address
1337 S Cesar E Chavez Dr
Milwaukee, WI 53204-2712
Phone (414) 897-5511
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8D4562 | Other | TX | BCBS |
| 169676703 | Medicaid | TX | |
| P00246197 | Other | TX | RAILROAD |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3031 | WI | MD | Chiropractor |
| 31248 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Frontiers TMS LLC | Single Specialty | Current | Accepting new patients |
| Psychology Associates of North Texas, P.a. | Psychologist | Past | Accepting new patients |
Locations
2675 N Mayfair Rd
Ste 400
Milwaukee, WI 53226
Phone (414) 350-2449
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.
-
- Psychologist
- Denton, TX
- NPI 1629147327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529884800000",
"number": "1134158751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1337 S CESAR E CHAVEZ DR",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532042712",
"telephone_number": "414-897-5511",
"fax_number": "414-385-7552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8204 ELMBROOK DR",
"address_2": "SUITE 360",
"city": "DALLAS",
"state": "TX",
"postal_code": "752474067",
"telephone_number": "214-219-0780",
"fax_number": "214-219-0782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINGWOOD",
"first_name": "LISA",
"middle_name": "MARIE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2018-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "WI",
"license": "3031",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8D4562",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "169676703",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00246197",
"state": "TX"
}
],
"endpoints": [],
"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 Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.