Individual provider Active NPI

Joel Kutner Levy, PH.D.

  • Clinical Neuropsychologist
  • Houston, TX
National Provider Identifier
1588784664
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
23083 Issued in TX
Practice address
6315 Gulfton St Ste 100
Houston, TX 77081-1107
Phone
(713) 457-4372
Fax
(713) 457-0945
NPI assigned
Mar 30, 2007
Last updated
Jun 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 23083 TX Primary
Psychologist 103T00000X NU

Addresses

Primary practice location

6315 Gulfton St Ste 100
Houston, TX 77081-1107

Mailing address

5534 Hummingbird St
Houston, TX 77096-4922
Phone (713) 569-9948

Other identifiers 2

IdentifierTypeStateIssuer
620005535OtherTXRAILROAD MEDICAREPROVIDER
23083OtherTXTEXAS PSYCHOLOGIST LIC.

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
I20120320000372 TX Practitioner - Clinical Psychologist 0648337311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kinghaven Counseling Group IncGroup PAC ID 5597898510, 14 clinicians

Practice addresses (Care Compare)

6100 Hillcroft Ave
Suite 642
Houston, TX 77081-1009
Phone (713) 457-4372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
23083TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kinghaven Counseling Group Inc Clinical Neuropsychologist CurrentSince Jan 18, 2012 Accepting new patients
Baylor College of Medicine Past Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

11811 FM 1960 Rd W
Ste 190
Houston, TX 77065
Phone (281) 894-4800

6100 Hillcroft Ave
Ste 642
Houston, TX 77081

6315 Gulfton St
Ste 100
Houston, TX 77081
Phone (713) 457-4357

2007 N Collins Blvd
Ste 303
Richardson, TX 75080
Phone (972) 947-4112

3025 E Renner Rd
Ste 120
Richardson, TX 75082
Phone (214) 257-0682

Organizations & group practices 3

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1588784664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5534 HUMMINGBIRD ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770964922",
            "telephone_number": "713-569-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6315 GULFTON ST STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770811107",
            "telephone_number": "713-457-4372",
            "fax_number": "713-457-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "JOEL",
        "middle_name": "KUTNER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "23083",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICAREPROVIDER",
            "identifier": "620005535",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS PSYCHOLOGIST LIC.",
            "identifier": "23083",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.