NPIMap

Organization Active NPI

Peace Psychology Center PLLC

  • Clinical Psychologist
  • Southlake, TX
National Provider Identifier
1295310001
Registry record updated Sep 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PEACE PSYCHOLOGY CENTER PLLC
Practice address
1723 E Southlake Blvd Ste 200
Southlake, TX 76092-6445
Phone
(817) 917-7348
NPI assigned
Mar 12, 2021
Last updated
Sep 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2022

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

Authorized official

Name
Dr. Kate Stark, PHDNPI 1043697774
Title
Manager and Licensed Psychologist
Phone
(817) 917-7348

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Psychologist 103T00000X
Cognitive & Behavioral Psychologist 103TB0200X
Clinical Psychologist 103TC0700X Primary
Clinical Child & Adolescent Psychologist 103TC2200X
Family Psychologist 103TF0000X
Intellectual & Developmental Disabilities Psychologist 103TM1800X
School Psychologist 103TS0200X

Addresses

Primary practice location

1723 E Southlake Blvd Ste 200
Southlake, TX 76092-6445

Mailing address

1723 E Southlake Blvd Ste 200
Southlake, TX 76092-6445
Phone (682) 292-7012

National Provider Directory

National Provider Directory

Locations

1723 E Southlake Blvd
Ste 200
Southlake, TX 76092
Phone (214) 494-1742

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662163200000",
    "number": "1295310001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 E SOUTHLAKE BLVD STE 200",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926445",
            "telephone_number": "682-292-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 E SOUTHLAKE BLVD STE 200",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926445",
            "telephone_number": "817-917-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE PSYCHOLOGY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2022-09-03",
        "certification_date": "2022-09-03",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "MANAGER AND LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "817-917-7348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.