Pennissi P Taylor, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

15762 Issued in TX

Practice address

205 Center Avenue
Brownwood, TX 76801-2919

Phone

(325) 649-4357

Fax

(325) 646-0919

NPI assigned

Feb 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Other, 1998

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

Locations

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.

• Pennissi P. Taylor PH.D,PC

  • Clinical Psychologist
  • Brownwood, TX
  • NPI 1114073830
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1194850370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1391",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768041391",
            "telephone_number": "325-649-4357",
            "fax_number": "325-646-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CENTER AVENUE",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768012919",
            "telephone_number": "325-649-4357",
            "fax_number": "325-646-0919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Needham St",
            "address_purpose": "LOCATION",
            "city": "Coleman",
            "state": "TX",
            "postal_code": "768345030",
            "country_code": "US",
            "telephone_number": "325-649-4357",
            "fax_number": "325-646-0919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2005 W Wallace St",
            "address_purpose": "LOCATION",
            "city": "San Saba",
            "state": "TX",
            "postal_code": "768773928",
            "country_code": "US",
            "telephone_number": "325-649-4357",
            "fax_number": "325-646-0919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "PENNISSI",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "TX",
            "license": "31191",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "15762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "203875",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "87411A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Synergistic Business Services Inc
• Duane Roger Talley, LPC
• Raissa Sarah Tankeu, PHARMD
• Jackson Taylor, LCSW
• James Taylor
• Rachel Taylor
• Timothy Leon Taylor, LPC
• Thomas L Teal III, DC
• Temple Vamc
• Michael Burton Terrill, ATC

• Clinical Psychologist in Brownwood, TX
• Providers in Brownwood, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.