Active NPI
Mellissa Tong, PSYD
- Clinical Psychologist
- Austin, TX
National Provider Identifier
1184241598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSYC.PY.60876120
- Practice address
- 508 Deep Eddy Ave
Austin, TX 78703-4555 - Phone
- (512) 956-6463
- NPI assigned
- Jul 1, 2020
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSYC.PY.60876120 | WA | Primary |
Addresses
Primary practice location
508 Deep Eddy Ave
Austin, TX 78703-4555
Mailing address
508 Deep Eddy Ave
Austin, TX 78703-4555
Phone (512) 956-6463
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSYC.PY.60876120 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616716800000",
"number": "1184241598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 DEEP EDDY AVE",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787034555",
"telephone_number": "512-956-6463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 DEEP EDDY AVE",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787034555",
"telephone_number": "512-956-6463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TONG",
"first_name": "MELLISSA",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-01",
"last_updated": "2021-03-26",
"certification_date": "2021-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PSYC.PY.60876120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.