Individual provider Active NPI

Samantha Leigh Janecek, PHD

  • Psychologist
  • Arlington, TX
National Provider Identifier
1427576198
Registry record updated Sep 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
37568 Issued in TX
Practice address
6043 W Interstate 20
Arlington, TX 76017-1042
Phone
(817) 533-0825
Fax
(817) 953-8899
NPI assigned
Sep 1, 2017
Last updated
Sep 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 37568 TX Primary
School Psychologist 103TS0200X 70823 TX

Addresses

Primary practice location

6043 W Interstate 20
Arlington, TX 76017-1042

Mailing address

5807 Goliad Ave
Dallas, TX 75206-6817

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

LicenseStateTypeSpecialty
37568TXMDDentist
37567TXMDOral and Maxillofacial Surgery (Dentist)
70823TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504224000000",
    "number": "1427576198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5807 GOLIAD AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752066817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6043 W INTERSTATE 20",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171042",
            "telephone_number": "817-533-0825",
            "fax_number": "817-953-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANECEK",
        "first_name": "SAMANTHA",
        "middle_name": "LEIGH",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-01",
        "last_updated": "2017-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "37568",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "TX",
            "license": "70823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; 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.