Individual provider Active NPI

Mary Damkroger, PH.D.

  • Counseling Psychologist
  • Plano, TX
National Provider Identifier
1639250343
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
31400 Issued in TX
Practice address
2800 N. Dallas Pkwy
Suite 220
Plano, TX 75093
Phone
(214) 682-8764
Fax
(972) 781-0203
NPI assigned
Oct 18, 2006
Last updated
Mar 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 31400 TX Primary

Addresses

Primary practice location

2800 N. Dallas Pkwy
Suite 220
Plano, TX 75093

Mailing address

2800 N. Dallas Pkwy
Suite 220
Plano, TX 75093
Phone (214) 682-8764

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
I20250317002153 TX Practitioner - Clinical Psychologist 2163944406 Practice locations: Plano, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2800 Dallas Pkwy
Suite 120
Plano, TX 75093-5994
Phone (214) 682-8764

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31400TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1639250343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N. DALLAS PKWY",
            "address_2": "SUITE 220",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "214-682-8764",
            "fax_number": "972-781-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N. DALLAS PKWY",
            "address_2": "SUITE 220",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "214-682-8764",
            "fax_number": "972-781-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMKROGER",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "31400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.