Individual provider Active NPI

Lynda J Ross, PH.D

  • Clinical Psychologist
  • Reno, NV
National Provider Identifier
1275847709
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0632 Issued in NV
Practice address
2450 Vassar St
3A
Reno, NV 89502
Phone
(775) 219-9015
Fax
(775) 853-8545
NPI assigned
Jul 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IP100514 NV
Clinical Psychologist 103TC0700X PY0632 NV Primary

Addresses

Primary practice location

2450 Vassar St
3A
Reno, NV 89502

Mailing address

1285 Spice Islands Dr
Sparks, NV 89431
Phone (775) 219-9015

Other identifiers 1

IdentifierTypeStateIssuer
V107908MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20140702002516 NV Practitioner - Clinical Psychologist 0345465407 Reassigns benefits to 1 organization
Practice locations: Reno, NV

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2450 Vassar St
Suite 3a
Reno, NV 89502-3249
Phone (775) 219-9015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
IP100514NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada Psych Eval Inc CurrentSince Sep 11, 2016 Accepting new patients

Locations

2450 Vassar St
Ste 3A
Reno, NV 89502
Phone (775) 200-1232

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1275847709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 SPICE ISLANDS DR",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "89431",
            "telephone_number": "775-219-9015",
            "fax_number": "775-853-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 VASSAR ST",
            "address_2": "3A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89502",
            "telephone_number": "775-219-9015",
            "fax_number": "775-853-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "LYNDA",
        "middle_name": "J",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "IP100514",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY0632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "V107908",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.