Active NPI
Allison Mary Stuppy-Sullivan
- Clinical Psychologist
- Pflugerville, TX
National Provider Identifier
1508353095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 39341
- Practice address
- 305 N Heatherwilde Blvd Ste 310
Pflugerville, TX 78660-4195 - Phone
- (443) 812-3584
- NPI assigned
- Apr 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 39341 | TX | Primary |
Addresses
Primary practice location
305 N Heatherwilde Blvd Ste 310
Pflugerville, TX 78660-4195
Mailing address
3505 Plover Run TRL
Pflugerville, TX 78660-3751
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39341 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658793600000",
"number": "1508353095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3505 PLOVER RUN TRL",
"city": "PFLUGERVILLE",
"state": "TX",
"postal_code": "786603751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 N HEATHERWILDE BLVD STE 310",
"city": "PFLUGERVILLE",
"state": "TX",
"postal_code": "786604195",
"telephone_number": "443-812-3584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUPPY-SULLIVAN",
"first_name": "ALLISON",
"middle_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-19",
"last_updated": "2022-07-26",
"certification_date": "2022-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "39341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pflugerville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.