Connie M Siciliano Avila, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

37241 Issued in TX

Practice address

735 Justin Rd
Rockwall, TX 75087-4840

Phone

(214) 830-9879

NPI assigned

Apr 11, 2018

Last updated

Jan 31, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Mindsprouts Personal Growth Therapy PLLC

  • Counseling Psychologist
  • Dallas, TX
  • NPI 1730635053
  NPD Authorized official

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1174020622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863842",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750863842",
            "telephone_number": "214-830-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 JUSTIN RD",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874840",
            "telephone_number": "214-830-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICILIANO AVILA",
        "first_name": "CONNIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "37241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard Shlensky, RPH
• Karri Shojaei-Scott, BCBA
• Sara Shorey, RDN
• Trudy Shryoc, L.AC.
• Hannah Shumake
• Carolyn W Sidereas, LPC
• Cristina Marie Sifuentes, LPC
• Erin Zeynep Silav, M.D.
• Sim-Meds Inc.
• Andrew Simmons, LPC

• Counseling Psychologist in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.