Manuel Harty Edquist, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

21060 Issued in TX

Practice address

517 Lake Dr
China Spring, TX 76633-2631

Phone

(254) 315-5761

NPI assigned

Feb 13, 2006

Last updated

May 16, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Psychology Consultants, PLLC

  • Clinical Psychologist
  • Dallas, TX
  • NPI 1760453963
  NPD (past)

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305504000000",
    "number": "1528032083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 LAKE DR",
            "city": "CHINA SPRING",
            "state": "TX",
            "postal_code": "766332631",
            "telephone_number": "254-315-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 LAKE DR",
            "city": "CHINA SPRING",
            "state": "TX",
            "postal_code": "766332631",
            "telephone_number": "254-315-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDQUIST",
        "first_name": "MANUEL",
        "middle_name": "HARTY",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2011-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "21060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Berntson, LVN
• Kelley Eileen Brister, PTA
• Tori Paige Butler, PA-S
• Connection to Recovery, LLC
• Brett Michael Daniel
• Michelle M Graeter, LVN
• Taylor Renee Graves, M.S. CF-SLP
• Stephanie Habermann, M.S., CCC-SLP
• Heart of Texas Divine Living Assistance Services LLC (Divine Living Assistance Services)
• Carlla Hill

• Clinical Psychologist in China Spring, TX
• Providers in China Spring, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; 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.