Jacqueline Lanier, PHD LICENSED PSYCHOL
Individual provider Active NPI Psychologist · Seabrook, TX
NPI 1457319626 · NPPES record last updated Oct 25, 2015
Key facts
- NPI
- 1457319626
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 30800 (TX)
- Practice address
- 1201 Hardesty Ave
Seabrook, TX 77586-3832 - Phone
- (281) 474-1488
- Fax
- (281) 240-6481
- NPI assigned
- May 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1506 E Winding Way Dr
Suite 105
Friendswood, TX 77546-5391
Phone (281) 734-7707
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161010000551 | TX | Practitioner - Clinical Psychologist | 5092017889 | Practice locations: Friendswood, TX |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30800 | TX | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 30800 | TX | Yes |
Addresses
Primary practice location
1201 Hardesty Ave
Seabrook, TX 77586-3832
Mailing address
1201 Hardesty Ave
Seabrook, TX 77586-3832
Phone (281) 474-1488
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0068CY | Other | TX | BC/BS |
| 096507102 | Medicaid | TX |
Other providers in Seabrook, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.