Individual provider Active NPI

Velma Jean Stanley, PSYCHOLOGIST

  • Psychologist
  • Lufkin, TX
National Provider Identifier
1558464602
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
38601 Issued in TX
Practice address
103 Wildlife LN
Lufkin, TX 75904-1615
Phone
(936) 238-3868
Fax
(936) 238-3867
NPI assigned
Sep 6, 2006
Last updated
Feb 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 18536 TX
Psychologist 103T00000X 38601 TX Primary

Addresses

Primary practice location

103 Wildlife LN
Lufkin, TX 75904-1615

Mailing address

103 Wildlife LN
Lufkin, TX 75904-1615
Phone (936) 238-3868

Other identifiers 1

IdentifierTypeStateIssuer
162728303MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231113003169 TX Practitioner - Clinical Psychologist 4587011572 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18536TXMDMental Health Counselor
38601TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Forensic & Mental Health Services, PLLC Mental Health CurrentSince Oct 16, 2023 Accepting new patients

Locations

103 Wildlife Ln
Lufkin, TX 75904
Phone (936) 238-3868

602 S John Redditt Dr
Lufkin, TX 75904
Phone (936) 238-3868

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1558464602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WILDLIFE LN",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759041615",
            "telephone_number": "936-238-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WILDLIFE LN",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759041615",
            "telephone_number": "936-238-3868",
            "fax_number": "936-238-3867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "VELMA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "18536",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "38601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162728303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.