NPIMap

Organization Active NPI

Texas Tech University Psychology Clinic

  • Psychologist
  • Lubbock, TX
National Provider Identifier
1205044740
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
25048 Issued in TX
Legal business name
TEXAS TECH UNIVERSITY PSYCHOLOGY CLINIC
Practice address
18TH Street and Boston Avenue
Lubbock, TX 79409
Phone
(806) 742-3737
Fax
(806) 742-3799
NPI assigned
May 18, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen Wright Cook, PHDNPI 1093869695
Title
Clinic Director
Phone
(806) 742-3737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 25048 TX Primary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 23874 TX
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 23791 TX
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 32461 TX

Addresses

Primary practice location

18TH Street and Boston Avenue
Lubbock, TX 79409

Mailing address

PO Box 42051
Lubbock, TX 79409-2051
Phone (806) 742-3737

Other identifiers 3

IdentifierTypeStateIssuer
0012KDOtherTXBLUE CROSS BLUE SHIELD
04238.4OtherTXINTERFACE EAP
TEXAS0004 TEXAS 0011OtherTXCOMP CARE FIRST CARE

National Provider Directory

National Provider Directory
Tax ID family
OB and GYN Clinical Lab7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205044740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42051",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794092051",
            "telephone_number": "806-742-3737",
            "fax_number": "806-742-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18TH STREET AND BOSTON AVENUE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79409",
            "telephone_number": "806-742-3737",
            "fax_number": "806-742-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS TECH UNIVERSITY PSYCHOLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "WRIGHT",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "806-742-3737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "25048",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "23874",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "23791",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "32461",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0012KD",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERFACE EAP",
            "identifier": "04238.4",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMP CARE FIRST CARE",
            "identifier": "TEXAS0004 TEXAS 0011",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.