Cynthia Ann Mellor-Crummey, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

24287 Issued in TX

Practice address

101 Southwestern Blvd
Suite 211
Sugar Land, TX 77478-3668

Phone

(713) 813-6740

Fax

(713) 721-7174

NPI assigned

Jan 5, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 6, 2015 through Oct 6, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194873414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310387",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772310387",
            "telephone_number": "713-813-6740",
            "fax_number": "713-721-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SOUTHWESTERN BLVD",
            "address_2": "SUITE 211",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783668",
            "telephone_number": "713-813-6740",
            "fax_number": "713-721-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLOR-CRUMMEY",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "24287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS PROVIDER #",
            "identifier": "022594",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "0027CM",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.