Organization Active NPI

NGWG Psychological Services, PLLC

  • Psychologist
  • Addison, TX
National Provider Identifier
1639632920
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
NGWG PSYCHOLOGICAL SERVICES, PLLC
Practice address
14665 Midway Rd Ste 110
Addison, TX 75001-3185
Phone
(972) 382-9992
NPI assigned
Apr 12, 2019
Organization subpart
Yes
Parent organization
NEXTGEN WELLNESS GROUP INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Authorized official

Name
Hunter Jochem
Title
Ceo
Phone
(972) 382-9992

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

14665 Midway Rd Ste 110
Addison, TX 75001-3185

Mailing address

14665 Midway Rd Ste 110
Addison, TX 75001-3185
Phone (972) 382-9992

National Provider Directory

National Provider Directory
Part of
Nextgen Wellness Group Inc

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1639632920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14665 MIDWAY RD STE 110",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013185",
            "telephone_number": "972-382-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14665 MIDWAY RD STE 110",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013185",
            "telephone_number": "972-382-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGWG PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEXTGEN WELLNESS GROUP INC.",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "JOCHEM",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-382-9992"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.