Active NPI
Anaiya Baukman, M.S., LPA
- Clinical Psychologist
- Irving, TX
National Provider Identifier
1164137188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 40159
- Practice address
- 1175 Kinwest Pkwy Ste 100
Irving, TX 75063-3409 - Phone
- (214) 940-9089
- NPI assigned
- Jan 16, 2023
- Last updated
- May 20, 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 40159 | TX | Primary |
Addresses
Primary practice location
1175 Kinwest Pkwy Ste 100
Irving, TX 75063-3409
Mailing address
9595 Rombauer Rd Apt 202
Coppell, TX 75019-1203
Phone (484) 994-9478
Other practice location 1
9595 Rombauer Rd # 202
Coppell, TX 75019-5891
Phone (484) 994-9478
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40159 | Other | TX | TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL |
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40159 | TX | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Impact Psychological Assessments, PLLC | Current | Accepting new patients | |
| Dallas Therapeutic Services PLLC | Past | Accepting new patients |
Locations
1175 Kinwest Pkwy
Ste 100
Irving, TX 75063
Phone (214) 940-9089
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Irving, TX
- NPI 1467139188
-
- Psychologist
- Irving, TX
- NPI 1932674132
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1164137188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9595 ROMBAUER RD APT 202",
"city": "COPPELL",
"state": "TX",
"postal_code": "750191203",
"telephone_number": "484-994-9478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 KINWEST PKWY STE 100",
"city": "IRVING",
"state": "TX",
"postal_code": "750633409",
"telephone_number": "214-940-9089"
}
],
"practiceLocations": [
{
"address_1": "9595 Rombauer Rd # 202",
"address_purpose": "LOCATION",
"city": "Coppell",
"state": "TX",
"postal_code": "750195891",
"country_code": "US",
"telephone_number": "484-994-9478",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAUKMAN",
"first_name": "ANAIYA",
"name_prefix": "Ms.",
"credential": "M.S., LPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-16",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "40159",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL",
"identifier": "40159",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.