Active NPI
William G Yeatts, PSYD
- Clinical Psychologist
- Dallas, TX
National Provider Identifier
1376873729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 15288
- Practice address
- 5606 Smu Blvd # 600723
Dallas, TX 75206-5018 - Phone
- (469) 323-7076
- Fax
- (888) 778-1449
- NPI assigned
- Jan 7, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | |||
| Clinical Psychologist | 103TC0700X | 15288 | TX | Primary |
| Psychologist | 103T00000X | 15288 | TX | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 15288 | TX |
Addresses
Primary practice location
5606 Smu Blvd # 600723
Dallas, TX 75206-5018
Mailing address
5606 Smu Blvd # 600723
Dallas, TX 75206-5018
Phone (469) 323-7076
Other practice location 1
5508 Anita St
Dallas, TX 75206-5306
Phone (469) 323-7076
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130 | Other | TX | SHARS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1376873729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5606 SMU BLVD # 600723",
"city": "DALLAS",
"state": "TX",
"postal_code": "752065018",
"telephone_number": "469-323-7076",
"fax_number": "888-778-1449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5606 SMU BLVD # 600723",
"city": "DALLAS",
"state": "TX",
"postal_code": "752065018",
"telephone_number": "469-323-7076",
"fax_number": "888-778-1449"
}
],
"practiceLocations": [
{
"address_1": "5508 Anita St",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752065306",
"country_code": "US",
"telephone_number": "469-323-7076",
"fax_number": "888-778-1449",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YEATTS",
"first_name": "WILLIAM",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-07",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "15288",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "15288",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "TX",
"license": "15288",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SHARS",
"identifier": "130",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.