Individual provider Active NPI

Katherine Rose, PSY.D

  • Clinical Psychologist
  • Dallas, TX
National Provider Identifier
1427417930
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37026 Issued in TX
Practice address
11300 N Central Expy Ste 610
Dallas, TX 75243-6714
Phone
(610) 675-7390
NPI assigned
Feb 12, 2016
Last updated
Feb 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 37026 TX Primary

Addresses

Primary practice location

11300 N Central Expy Ste 610
Dallas, TX 75243-6714

Mailing address

11300 N Central Expy Ste 610
Dallas, TX 75243-6714
Phone (610) 675-7390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251104002925 TX Practitioner - Clinical Psychologist 5496245946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1345 Philomena St
Austin, TX 78723-3210

4900 Mueller Blvd
Austin, TX 78723-3051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37026TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Clinical Current Accepting new patients
Tri-County Clinical CurrentSince Aug 7, 2025 Accepting new patients

Locations

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

Interoperability endpoints

  • Direct secure messaging: katherine.rose.1@8363.direct.athenahealth.com

Organizations & group practices 2

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": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1427417930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 N CENTRAL EXPY STE 610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752436714",
            "telephone_number": "610-675-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 N CENTRAL EXPY STE 610",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752436714",
            "telephone_number": "610-675-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.