Active NPI
Carolyn Sasano, PHD
- Psychologist
- Bedford, TX
National Provider Identifier
1578701074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 34824
- Practice address
- 1305 Airport Fwy Ste 205
Bedford, TX 76021-6606 - Phone
- (817) 267-6290
- Fax
- (817) 267-0950
- NPI assigned
- Jan 22, 2009
- Last updated
- Mar 17, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 34824 | TX | Primary |
| School Psychologist | 103TS0200X | 31664 | TX |
Addresses
Primary practice location
1305 Airport Fwy Ste 205
Bedford, TX 76021-6606
Mailing address
1305 Airport Fwy Ste 205
Bedford, TX 76021-6606
Phone (817) 267-6290
Other practice location 1
110 W Randol Mill Rd
Arlington, TX 76011-4611
Phone (888) 888-8888
Other practice location 2
104 Maverick St # B
Aledo, TX 76008-4450
Phone (817) 771-1722
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01452126 | Other | TX | AMERIGROUP |
| 2140089 | Medicaid | TX | |
| TXB148104 | Other | TX | MEDICARE PTAN NUMBER |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34824 | TX | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CPST Healthcare, LLC | Psychologist | Past | Accepting new patients |
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.
-
- Psychologist
- Fort Worth, TX
- NPI 1467211862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1578701074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 AIRPORT FWY STE 205",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760216606",
"telephone_number": "817-267-6290",
"fax_number": "817-267-0950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 AIRPORT FWY STE 205",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760216606",
"telephone_number": "817-267-6290",
"fax_number": "817-267-0950"
}
],
"practiceLocations": [
{
"address_1": "110 W Randol Mill Rd",
"address_purpose": "LOCATION",
"city": "Arlington",
"state": "TX",
"postal_code": "760114611",
"country_code": "US",
"telephone_number": "888-888-8888",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "104 Maverick St # B",
"address_purpose": "LOCATION",
"city": "Aledo",
"state": "TX",
"postal_code": "760084450",
"country_code": "US",
"telephone_number": "817-771-1722",
"fax_number": "888-848-6827",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SASANO",
"first_name": "CAROLYN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-22",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "34824",
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "TX",
"license": "31664",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "01452126",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2140089",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN NUMBER",
"identifier": "TXB148104",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bedford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.