Individual provider Active NPI

Marsha Siebenmorgen, PHD, LP

  • Clinical Child & Adolescent Psychologist
  • Dallas, TX
National Provider Identifier
1649670415
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
37734 Issued in TX
Practice address
2222 Medical District Dr
Dallas, TX 75235-8075
Phone
(214) 867-6923
NPI assigned
Aug 29, 2014
Last updated
Mar 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2567 KS
Clinical Child & Adolescent Psychologist 103TC2200X 37734 TX Primary

Addresses

Primary practice location

2222 Medical District Dr
Dallas, TX 75235-8075

Mailing address

2801 N Rock Rd
#1608
Wichita, KS 67226-1192
Phone (918) 293-2646

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
I20250204004005 TX Practitioner - Clinical Psychologist 7618407727 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2567KSMDClinical Psychologist
37734TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Health System of Texas CurrentSince Jan 22, 2025 Accepting new patients
Children's Health System of Texas CurrentSince Jan 22, 2025 Accepting new patients

Locations

1935 Medical District Dr
#908
Dallas, TX 75235

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

Organizations & group practices 2

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": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1649670415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 N ROCK RD",
            "address_2": "#1608",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672261192",
            "telephone_number": "918-293-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752358075",
            "telephone_number": "214-867-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBENMORGEN",
        "first_name": "MARSHA",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-29",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "2567",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TX",
            "license": "37734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.