Andrea Kirby, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

37298 Issued in TX

Practice address

1340 N White Chapel Blvd Ste 130
Southlake, TX 76092-4327

Phone

(817) 381-5259

NPI assigned

Jun 10, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Therlively

  • Clinical Psychologist
  • Southlake, TX
  • NPI 1063282929
  NPD Authorized official

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1417306333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 N WHITE CHAPEL BLVD STE 130",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760924327",
            "telephone_number": "817-381-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 N WHITE CHAPEL BLVD STE 130",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760924327",
            "telephone_number": "817-381-5259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Oak Lawn Ave",
            "address_2": "Suite 230",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752194308",
            "country_code": "US",
            "telephone_number": "919-244-4484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Murphy King, MD
• Kelly King, RD, LD, CDCES
• Lori Massey King, MD
• Shaina A King, MSN, PHMNP-BC
• Kinsley Consulting LLC
• Cameron Danielle Kirby
• Emily Kirby, RBT
• Megan Kirkpatrick, RBT
• KJK Eye Care LLC (Southlake Family Eye Care)
• Marla Jan Klein

• Clinical Psychologist in Southlake, TX
• Providers in Southlake, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.