Individual provider Active NPI

Poonam Avinashi Vinchhi Dubal, LP, LSSP

  • Psychologist
  • Dallas, TX
National Provider Identifier
1205338076
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
37360 Issued in TX
Practice address
4925 Greenville Ave Ste 1050
Dallas, TX 75206-4084
Phone
(214) 918-1999
NPI assigned
Mar 7, 2018
Last updated
Oct 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 37360 TX Primary
School Psychologist 103TS0200X 70804 TX

Addresses

Primary practice location

4925 Greenville Ave Ste 1050
Dallas, TX 75206-4084

Mailing address

4925 Greenville Ave Ste 1050
Dallas, TX 75206-4084
Phone (214) 918-1999

Other practice location 1

8390 Lbj Fwy Ste 575
Dallas, TX 75243-1188
Phone (214) 918-1999

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180322002552 TX Practitioner - Clinical Psychologist 0840552212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carewright Clinical Services, PLLCGroup PAC ID 7315119518, 33 clinicians

Practice addresses (Care Compare)

4925 Greenville Ave
Suite 1050
Dallas, TX 75206-4084
Phone (214) 918-1999

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carewright Clinical Services, PLLC Psychologist CurrentSince May 29, 2018 Accepting new patients

Locations

4925 Greenville Ave
Ste 1050
Dallas, TX 75206

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1205338076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 GREENVILLE AVE STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064084",
            "telephone_number": "214-918-1999",
            "fax_number": "972-850-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 GREENVILLE AVE STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064084",
            "telephone_number": "214-918-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8390 Lbj Fwy Ste 575",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752431188",
            "country_code": "US",
            "telephone_number": "214-918-1999",
            "fax_number": "972-850-9452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBAL",
        "first_name": "POONAM",
        "middle_name": "AVINASHI VINCHHI",
        "credential": "LP, LSSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "37360",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "TX",
            "license": "70804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.