Active NPI
George H. Withers PH.D., PHD
- Clinical Psychologist
- Austin, TX
National Provider Identifier
1407079361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 22835
- Practice address
- 4400 Medical Pkwy
Austin, TX 78756-3314 - Phone
- (512) 459-6000
- NPI assigned
- Apr 10, 2007
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Professional Counselor | 101YP2500X | |||
| Psychologist | 103T00000X | |||
| Adult Development & Aging Psychologist | 103TA0700X | |||
| Clinical Psychologist | 103TC0700X | 22835 | TX | Primary |
| Family Psychologist | 103TF0000X |
Addresses
Primary practice location
4400 Medical Pkwy
Austin, TX 78756-3314
Mailing address
PO Box 302643
Austin, TX 78703-0045
Phone (512) 459-6000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102985203 | Medicaid | TX | |
| 680013958 | Other | TX | RR MEDICARE NUMBER |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22835 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1407079361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 302643",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787030045",
"telephone_number": "512-459-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 MEDICAL PKWY",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787563314",
"telephone_number": "512-459-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITHERS PH.D.",
"first_name": "GEORGE",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-10",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "22835",
"primary": true
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102985203",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE NUMBER",
"identifier": "680013958",
"state": "TX"
}
],
"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 Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.