Individual provider Active NPI

Kristy L Lacko, PSY.D.

  • Clinical Psychologist
  • Killeen, TX
National Provider Identifier
1427321314
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
36749 Issued in TX
Practice address
3800 S W S Young Dr Ste 407
Killeen, TX 76542-3374
Phone
(254) 252-3748
Fax
(254) 549-0086
NPI assigned
Feb 22, 2012
Last updated
Feb 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 24531 CA
Clinical Psychologist 103TC0700X 36749 TX Primary

Addresses

Primary practice location

3800 S W S Young Dr Ste 407
Killeen, TX 76542-3374

Mailing address

2330 Stanley Rd
Suite C
Fort Sam Houston, TX 78234-2636

Other practice location 1

2330 Stanley Rd
Suite C
Fort Sam Houston, TX 78234-2636
Phone (210) 221-1211

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

State licenses

LicenseStateTypeSpecialty
24531CAMDDentist
36749TXMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen T. Belk Psy.D. PLLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1427321314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 STANLEY RD",
            "address_2": "SUITE C",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782342636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S W S YOUNG DR STE 407",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765423374",
            "telephone_number": "254-252-3748",
            "fax_number": "254-549-0086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2330 Stanley Rd",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782342636",
            "country_code": "US",
            "telephone_number": "210-221-1211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACKO",
        "first_name": "KRISTY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-22",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24531",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.

Verify at the official NPI Registry.