Western Plains Psychology P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

605 Issued in NE

Legal business name

WESTERN PLAINS PSYCHOLOGY P.C.

Practice address

3911 Ave B, Suite 3400
South Plaza
Scottsbluff, NE 69361

Phone

(308) 630-7966

Fax

(308) 630-1028

NPI assigned

Oct 25, 2010

Last updated

Oct 25, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole White-Vidlak, PH.D.

Title

Ower/Pres.

Phone

(308) 630-7966

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287964800000",
    "number": "1548560584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1367",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693631367",
            "telephone_number": "308-630-7966",
            "fax_number": "308-630-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 AVE B, SUITE 3400",
            "address_2": "SOUTH PLAZA",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "69361",
            "telephone_number": "308-630-7966",
            "fax_number": "308-630-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN PLAINS PSYCHOLOGY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A",
        "authorized_official_last_name": "WHITE-VIDLAK",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWER/PRES.",
        "authorized_official_telephone_number": "308-630-7966",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NE",
            "license": "605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025891800",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.