Organization Active NPI

Ar Psychological Services PLLC

  • Clinical Psychologist
  • Southlake, TX
National Provider Identifier
1467892810
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
34091
Legal business name
AR PSYCHOLOGICAL SERVICES PLLC
Practice address
231 E Southlake Blvd
Suite 140
Southlake, TX 76092-6285
Phone
(908) 720-3118
NPI assigned
Jun 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Authorized official

Name
Dr. Amanpreet Randazzo, PSYDNPI 1467696823
Title
Ceo
Phone
(908) 720-3118

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 34091 Primary

Addresses

Primary practice location

231 E Southlake Blvd
Suite 140
Southlake, TX 76092-6285

Mailing address

231 E Southlake Blvd
Suite 140
Southlake, TX 76092-6285
Phone (908) 720-3118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130917000486 TX Part B Supplier - Clinic/Group Practice 2668616434 Receives reassigned benefits from 5 practitioners
Practice locations: Southlake, TX

National Provider Directory

National Provider Directory

Locations

231 E Southlake Blvd
Ste 140
Southlake, TX 76092
Phone (817) 381-8161

Practitioners & affiliated clinicians

Practitioners 5

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": "1372550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405987200000",
    "number": "1467892810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 E SOUTHLAKE BLVD",
            "address_2": "SUITE 140",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926285",
            "telephone_number": "908-720-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E SOUTHLAKE BLVD",
            "address_2": "SUITE 140",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926285",
            "telephone_number": "908-720-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AR PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-30",
        "last_updated": "2014-07-22",
        "status": "A",
        "authorized_official_last_name": "RANDAZZO",
        "authorized_official_first_name": "AMANPREET",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "908-720-3118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": "34091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.