Shawn Knadler, PSY.D.
Individual provider Active NPI Clinical Psychologist · Jbsa-Lackland Afb, TX
NPI 1275945586 · NPPES record last updated May 9, 2022
Key facts
- NPI
- 1275945586
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY.0004761 (CO)
- Practice address
- 1100 Wilford Hall Loop, Bldg5445
Jbsa-Lackland Afb, TX 78236-9908 - Phone
- (210) 292-6225
- NPI assigned
- May 21, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY.0004761 | CO | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY.0004761 | CO | Yes |
Addresses
Primary practice location
1100 Wilford Hall Loop, Bldg5445
Jbsa-Lackland Afb, TX 78236-9908
Mailing address
1100 Wilford Hall Loop
BLDG 5445
Jbsa Lackland, TX 78236-9908
Phone (219) 292-6225
Other providers in Jbsa-Lackland Afb, TX
- Michelle Lora Floyd
- Benjamin Jordan Franklin
- Phyllis Gallegos Santillan
- Blake Austin Harrell
- Jessica Rose White Harvey
- Seth Daniel Knapp
- Jason A Koskinen
- Jeffrey Alan Lawson
- Dena Louise Lewis
- John Anthony Mireles III
All providers in Jbsa-Lackland Afb, TX · Clinical Psychologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.