Active NPI
Nicole R Bartholomew, PH.D.
- Counseling Psychologist
- Dallas, TX
National Provider Identifier
1215628326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 37158
- Practice address
- 12200 Ford Rd
Dallas, TX 75234 - Phone
- (682) 703-0587
- NPI assigned
- May 18, 2023
- Last updated
- May 18, 2023
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 37158 | TX | Primary |
Addresses
Primary practice location
12200 Ford Rd
Dallas, TX 75234
Mailing address
12650 N Beach Street
Ste 114, #7094
Fort Worth, TX 76244
Phone (682) 703-0587
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37158 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684368000000",
"number": "1215628326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12650 N BEACH STREET",
"address_2": "STE 114, #7094",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76244",
"telephone_number": "682-703-0587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12200 FORD RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "75234",
"telephone_number": "682-703-0587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARTHOLOMEW",
"first_name": "NICOLE",
"middle_name": "R",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-18",
"last_updated": "2023-05-18",
"certification_date": "2023-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "TX",
"license": "37158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.