Active NPI
Dana Marie Ferris, PHD
- Clinical Psychologist
- Austin, TX
National Provider Identifier
1639277809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 24530
- Practice address
- 4701 West Gate Blvd
Building D #403
Austin, TX 78745 - Phone
- (512) 462-0056
- NPI assigned
- Sep 20, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 24530 | TX | Primary |
Addresses
Primary practice location
4701 West Gate Blvd
Building D #403
Austin, TX 78745
Mailing address
PO Box 93042
Austin, TX 78709-3042
Phone (512) 462-0056
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0058CM | Other | TX | BCBS |
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 |
|---|---|---|---|
| 24530 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206489600000",
"number": "1639277809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 93042",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787093042",
"telephone_number": "512-462-0056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4701 WEST GATE BLVD",
"address_2": "BUILDING D #403",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78745",
"telephone_number": "512-462-0056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERRIS",
"first_name": "DANA",
"middle_name": "MARIE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2008-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "24530",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0058CM",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.