NPIMap

Individual provider Active NPI

Andreana T Augustus, PH.D.

  • Clinical Psychologist
  • Wichita Falls, TX
National Provider Identifier
1396915328
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37001 Issued in TX
Practice address
6515 Kemp Blvd
Wichita Falls, TX 76308-5419
Phone
(940) 692-1200
NPI assigned
Mar 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1365 NM
Clinical Psychologist 103TC0700X 37001 TX Primary
Forensic Psychologist 103TF0200X 1365 NM
Forensic Psychologist 103TF0200X 37001 TX
Group Psychotherapy Psychologist 103TP2701X 1365 NM
Group Psychotherapy Psychologist 103TP2701X 37001 TX
Cognitive & Behavioral Psychologist 103TB0200X 1365 NM
Cognitive & Behavioral Psychologist 103TB0200X 37001 TX

Addresses

Primary practice location

6515 Kemp Blvd
Wichita Falls, TX 76308-5419

Mailing address

6515 Kemp Blvd
Wichita Falls, TX 76308-5419

Other identifiers 1

IdentifierTypeStateIssuer
47043MedicaidNM

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

LicenseStateTypeSpecialty
1365NMMDGeneral Practice Dentistry
37001TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1396915328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6515 KEMP BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763085419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 KEMP BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763085419",
            "telephone_number": "940-692-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTUS",
        "first_name": "ANDREANA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "1365",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37001",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NM",
            "license": "1365",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "TX",
            "license": "37001",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NM",
            "license": "1365",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "TX",
            "license": "37001",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NM",
            "license": "1365",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "TX",
            "license": "37001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47043",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; 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.