Georgetown Psychotherapy, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

34032 Issued in TX

Legal business name

GEORGETOWN PSYCHOTHERAPY, PLLC

Doing business as

Piney Woods Psychological Services

Practice address

518 E Hospital Street
Nacogdoches, TX 75961

Phone

(936) 462-8577

Fax

(936) 228-9072

NPI assigned

Mar 11, 2010

Last updated

Jun 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sydney Kroll Register, PSYDNPI 1467638825

Title

Owner

Phone

(936) 462-8577

Specialties & licenses 1

Addresses

Other names 1

• Piney Woods Psychological Services Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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.

• Sydney Kroll Register, PSY.D.

  • Clinical Psychologist
  • Nacogdoches, TX
  • NPI 1467638825
  Medicare reassignment Care Compare group NPD Authorized official
• Lauren Marie Ivy Sieja, LCSW

  • Clinical Social Worker
  • Nacogdoches, TX
  • NPI 1629645155

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1225351794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 E HOSPITAL STREET",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75961",
            "telephone_number": "936-462-8577",
            "fax_number": "936-228-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 E HOSPITAL STREET",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75961",
            "telephone_number": "936-462-8577",
            "fax_number": "936-228-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN PSYCHOTHERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "REGISTER",
        "authorized_official_first_name": "SYDNEY",
        "authorized_official_middle_name": "KROLL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-462-8577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "34032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piney Woods Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Steven Garza Garcia, M.D.
• Giovonni Romia Garrett, MS, LAT, ATC
• Monica Lynn Gasaway
• Christopher L Gayden, D.O.
• Genoa Healthcare LLC
• Christa Counts Gibbs, LPC
• Katy Kepner Gibbs
• Sarah Elizabeth Gill, M.S. CCC-SLP
• Denver Lee Glass, PT, DPT
• Kristen Ruby Glass, PT, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.