Individual provider Active NPI

Blythe Twosisters, PSY.D.

  • Clinical Psychologist
  • Houston, TX
National Provider Identifier
1497191902
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
36566 Issued in TX
Practice address
2636 S Loop W Ste 550-a
Houston, TX 77054-2680
Phone
(432) 698-0141
Fax
(281) 605-6722
NPI assigned
May 13, 2013
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 36566 TX Primary

Addresses

Primary practice location

2636 S Loop W Ste 550-a
Houston, TX 77054-2680

Mailing address

2636 S Loop W Ste 550-a
Houston, TX 77054-2680
Phone (432) 698-0141

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200123000236 TX Practitioner - Clinical Psychologist 6002241973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2636 S Loop W
Suite 550a
Houston, TX 77054-2680
Phone (432) 698-0141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36566TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tabula Rasa Psychology, PLLC Clinical CurrentSince Jan 2, 2020 Accepting new patients

Locations

2339 Commerce St
Ste 135
Houston, TX 77002
Phone (432) 698-0141

2636 S Loop W
Ste 550A
Houston, TX 77054
Phone (432) 698-0141

448 W 19th St
Houston, TX 77008
Phone (210) 595-9247

5445 Almeda Rd
#407
Houston, TX 77004

5445 Almeda Rd
Ste 407
Houston, TX 77004
Phone (214) 997-4697

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1497191902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 S LOOP W STE 550-A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542680",
            "telephone_number": "432-698-0141",
            "fax_number": "281-605-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2636 S LOOP W STE 550-A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542680",
            "telephone_number": "432-698-0141",
            "fax_number": "281-605-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWOSISTERS",
        "first_name": "BLYTHE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-13",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.