NPIMap

Organization Active NPI

Impact Psychological Assessments, PLLC

  • Psychologist
  • Irving, TX
National Provider Identifier
1467139188
Registry record updated Jul 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
IMPACT PSYCHOLOGICAL ASSESSMENTS, PLLC
Practice address
1175 Kinwest Pkwy Ste 100
Irving, TX 75063-3409
Phone
(214) 940-9089
Fax
(469) 314-8706
NPI assigned
Jul 4, 2023
Last updated
Jul 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2023

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

Authorized official

Name
Chelsea Clicque, LP, LPCNPI 1649680679
Title
Owner
Phone
(972) 762-0956

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

1175 Kinwest Pkwy Ste 100
Irving, TX 75063-3409

Mailing address

4135 Wycliff Ave Apt 6
Dallas, TX 75219-3089
Phone (903) 530-0731

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688428800000",
    "number": "1467139188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 WYCLIFF AVE APT 6",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193089",
            "telephone_number": "903-530-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 KINWEST PKWY STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633409",
            "telephone_number": "214-940-9089",
            "fax_number": "469-314-8706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT PSYCHOLOGICAL ASSESSMENTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-04",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-04",
        "status": "A",
        "authorized_official_last_name": "CLICQUE",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-762-0956",
        "authorized_official_credential": "LP, LPC"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2023; 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.