Manuel Harty Edquist, PH.D.
Individual provider Active NPI Clinical Psychologist · China Spring, TX
NPI 1528032083 · NPPES record last updated May 16, 2011
Key facts
- NPI
- 1528032083
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 21060 (TX)
- Practice address
- 517 Lake Dr
China Spring, TX 76633-2631 - Phone
- (254) 315-5761
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21060 | TX | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychology Consultants, PLLC | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 21060 | TX | Yes |
Addresses
Primary practice location
517 Lake Dr
China Spring, TX 76633-2631
Mailing address
517 Lake Dr
China Spring, TX 76633-2631
Phone (254) 315-5761
Other providers in China Spring, TX
- Linda Berntson
- Kelley Eileen Brister
- Tori Paige Butler
- Connection to Recovery, LLC
- Brett Michael Daniel
- Michelle M Graeter
- Taylor Renee Graves
- Stephanie Habermann
- Heart of Texas Divine Living Assistance Services LLC
- Carlla Hill
All providers in China Spring, TX · Clinical Psychologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.