Rosslyn Douglas, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

36396 Issued in TX

Practice address

2600 S Shore Blvd Ste 300
League City, TX 77573-2944

Phone

(832) 425-8363

NPI assigned

Mar 29, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psy-Med, Inc.Group PAC ID 5092863662, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Psy-Med, Inc.

  • Health Psychologist
  • Dallas, TX
  • NPI 1881842102
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1437492311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 PALO DURO CANYON DR",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775736498",
            "telephone_number": "832-425-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S SHORE BLVD STE 300",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775732944",
            "telephone_number": "832-425-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "ROSSLYN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-29",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "36396",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine M Dolson, DDS
• Miranda Michelle Donahue
• Michelle L Dortch, A-GNP
• Terri Lynn Dotson, M.S. CCC/SLP
• Thomas Roy Dougherty, DDS
• Tasha Douglas, MASTERS OF EDUCATION
• Tiauna Lenea Douglas
• Brenda Emmanuelle Down, LMT
• John Meredith Doyle, D.C.
• Dr Gary Geaccone

• Clinical Psychologist in League City, TX
• Providers in League City, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.