Individual provider Active NPI

Carolyn Sasano, PHD

  • Psychologist
  • Bedford, TX
National Provider Identifier
1578701074
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
34824 Issued in TX
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, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01452126OtherTXAMERIGROUP
2140089MedicaidTX
TXB148104OtherTXMEDICARE 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

LicenseStateTypeSpecialty
34824TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
CPST Healthcare, LLC Psychologist PastSince Mar 1, 2024 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.

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.

Verify at the official NPI Registry.