Active NPI
Janet Scarborough Civitelli, PH.D.
- Psychologist
- Austin, TX
National Provider Identifier
1336691708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 34252
- Practice address
- 1401 Lavaca St Ste 40896
Austin, TX 78701-1634 - Phone
- (512) 348-8468
- Fax
- (512) 265-9722
- NPI assigned
- Nov 1, 2016
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 34252 | TX | Primary |
Addresses
Primary practice location
1401 Lavaca St Ste 40896
Austin, TX 78701-1634
Mailing address
1401 Lavaca St Ste 40896
Austin, TX 78701-1634
Phone (512) 348-8468
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 2, 2023 through Nov 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34252 | TX | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1336691708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 LAVACA ST STE 40896",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787011634",
"telephone_number": "512-348-8468",
"fax_number": "512-265-9722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 LAVACA ST STE 40896",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787011634",
"telephone_number": "512-348-8468",
"fax_number": "512-265-9722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIVITELLI",
"first_name": "JANET",
"middle_name": "SCARBOROUGH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-01",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "34252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.