Active NPI
Monica Marie Lackups-Fuentes, PH.D., L.P.
- Clinical Psychologist
- Houston, TX
National Provider Identifier
1558096024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 39306
- Practice address
- 7575 Cambridge St Apt 3201
Houston, TX 77054-2037 - Phone
- (210) 542-0028
- NPI assigned
- Jul 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 39306 | TX | Primary |
Addresses
Primary practice location
7575 Cambridge St Apt 3201
Houston, TX 77054-2037
Mailing address
7575 Cambridge St Apt 3201
Houston, TX 77054-2037
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | SimplePractice.com |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39306 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658188800000",
"number": "1558096024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7575 CAMBRIDGE ST APT 3201",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770542037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7575 CAMBRIDGE ST APT 3201",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770542037",
"telephone_number": "210-542-0028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACKUPS-FUENTES",
"first_name": "MONICA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PH.D., L.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-19",
"last_updated": "2022-07-19",
"certification_date": "2022-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "39306",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "SimplePractice.com",
"affiliation": "N",
"address_1": "7575 Cambridge St Apt 3201",
"city": "Houston",
"state": "TX",
"country_code": "US",
"postal_code": "770542037",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.