Active NPI
Philip R. Taft Psy.D. PLLC
- Psychologist
- Corsicana, TX
National Provider Identifier
1366628331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Legal business name
- PHILIP R. TAFT PSY.D. PLLC
- Practice address
- 715 W 2ND Ave
Corsicana, TX 75110-3012 - Phone
- (903) 872-4442
- Fax
- (903) 642-2550
- NPI assigned
- Jan 21, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Philip Raymond Taft, PSY.D.
- Title
- Clinical Psychologist &Manager
- Phone
- (903) 872-4442
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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Psychologist | 103T00000X | Primary | ||
| Clinical Psychologist | 103TC0700X | |||
| Clinical Social Worker | 1041C0700X |
Addresses
Primary practice location
715 W 2ND Ave
Corsicana, TX 75110-3012
Mailing address
1106 Oaklawn Dr
Corsicana, TX 75110-2848
Phone (903) 872-4442
Other practice location 1
401 S Martin Luther King Jr Hwy
Mexia, TX 76667-3540
Phone (903) 872-4443
Other practice location 2
16 N Gate Dr
Waxahachie, TX 75165-2378
Phone (903) 872-4443
Other practice location 3
6801 Sanger Ave Ste 101
Waco, TX 76710-7807
Phone (903) 872-4442
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0073MG | Other | TX | BLUE CROSS BLUE SHIELD TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041119000754 | TX | Part B Supplier - Clinic/Group Practice | 6204891138 |
Receives reassigned benefits from 14 practitioners Practice locations: Corsicana, TX; Mexia, TX; Waco, TX; Waxahachie, TX |
National Provider Directory
National Provider DirectoryLocations
2000 W 2nd Ave
#B
Corsicana, TX 75110
Phone (903) 872-4442
715 W 2nd Ave
Corsicana, TX 75110
Phone (903) 872-4442
401 S Martin Luther King Jr Hwy
Mexia, TX 76667
Phone (903) 872-4443
6801 Sanger Ave
Ste 104
Waco, TX 76710
Phone (254) 751-9606
6801 Sanger Ave
Ste 101
Waco, TX 76710
Phone (903) 872-4442
16 N Gate Dr
Waxahachie, TX 75165
Phone (903) 872-4443
Practitioners & affiliated clinicians
Practitioners 21
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Professional Counselor
- Corsicana, TX
- NPI 1023769411
Professional, TX
-
- Professional Counselor
- Red Oak, TX
- NPI 1275246720
Professional, TX
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200873600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1720224000000",
"number": "1366628331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1106 OAKLAWN DR",
"city": "CORSICANA",
"state": "TX",
"postal_code": "751102848",
"telephone_number": "903-872-4442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 W 2ND AVE",
"city": "CORSICANA",
"state": "TX",
"postal_code": "751103012",
"telephone_number": "903-872-4442",
"fax_number": "903-642-2550"
}
],
"practiceLocations": [
{
"address_1": "401 S Martin Luther King Jr Hwy",
"address_purpose": "LOCATION",
"city": "Mexia",
"state": "TX",
"postal_code": "766673540",
"country_code": "US",
"telephone_number": "903-872-4443",
"fax_number": "903-872-2125",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16 N Gate Dr",
"address_purpose": "LOCATION",
"city": "Waxahachie",
"state": "TX",
"postal_code": "751652378",
"country_code": "US",
"telephone_number": "903-872-4443",
"fax_number": "903-872-2125",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6801 Sanger Ave Ste 101",
"address_purpose": "LOCATION",
"city": "Waco",
"state": "TX",
"postal_code": "767107807",
"country_code": "US",
"telephone_number": "903-872-4442",
"fax_number": "903-642-2550",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "PHILIP R. TAFT PSY.D. PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-21",
"last_updated": "2024-07-06",
"certification_date": "2024-07-06",
"status": "A",
"authorized_official_last_name": "TAFT",
"authorized_official_first_name": "PHILIP",
"authorized_official_middle_name": "RAYMOND",
"authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST &MANAGER",
"authorized_official_telephone_number": "903-872-4442",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PSY.D."
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD TX",
"identifier": "0073MG",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corsicana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2024; 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.