Active NPI
Nicole Anderson, PHD
- School Psychologist
- Webster, TX
National Provider Identifier
1386285567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 35138
- Practice address
- 17100 Glenmount Park Dr Ste C
Webster, TX 77598-4368 - Phone
- (281) 407-5658
- NPI assigned
- Sep 30, 2019
- Last updated
- Sep 30, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 35138 | TX | |
| School Psychologist | 103TS0200X | 35138 | TX | Primary |
Addresses
Primary practice location
17100 Glenmount Park Dr Ste C
Webster, TX 77598-4368
Mailing address
5521 Aspen St
Houston, TX 77081-6603
Phone (713) 702-8195
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35138 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569801600000",
"number": "1386285567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5521 ASPEN ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770816603",
"telephone_number": "713-702-8195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17100 GLENMOUNT PARK DR STE C",
"city": "WEBSTER",
"state": "TX",
"postal_code": "775984368",
"telephone_number": "281-407-5658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "NICOLE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-30",
"last_updated": "2019-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "TX",
"license": "35138",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "TX",
"license": "35138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Webster, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.