Active NPI
Kylin Lee
- Clinical Psychologist
- Austin, TX
National Provider Identifier
1417386798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 36005
- Practice address
- 14730 Single Trce
Austin, TX 78728-4344 - Phone
- (972) 322-5408
- NPI assigned
- Nov 6, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 36005 | TX | Primary |
Addresses
Primary practice location
14730 Single Trce
Austin, TX 78728-4344
Mailing address
14730 Single Trce
Austin, TX 78728-4344
Phone (972) 322-5408
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 1, 2024 through Nov 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36005 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383696000000",
"number": "1417386798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14730 SINGLE TRCE",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787284344",
"telephone_number": "972-322-5408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14730 SINGLE TRCE",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787284344",
"telephone_number": "972-322-5408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "KYLIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-06",
"last_updated": "2013-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "36005",
"primary": true
}
],
"identifiers": [],
"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 Nov 6, 2013; 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.