Active NPI
Cameron Todd Alldredge, PHD
- Clinical Psychologist
- Waco, TX
National Provider Identifier
1669245114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 39810
- Practice address
- 801 Washington Ave # 260.02
Waco, TX 76701-1282 - Phone
- (254) 265-8893
- NPI assigned
- Nov 6, 2023
- Last updated
- Nov 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 13021318-2501 | UT | |
| Clinical Psychologist | 103TC0700X | 39810 | TX | Primary |
Addresses
Primary practice location
801 Washington Ave # 260.02
Waco, TX 76701-1282
Mailing address
153 Lindenwood LN N
Hewitt, TX 76643-3035
Phone (801) 376-3202
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13021318-2501 | UT | MD | Clinical Psychologist |
| 39810 | TX | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1669245114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 LINDENWOOD LN N",
"city": "HEWITT",
"state": "TX",
"postal_code": "766433035",
"telephone_number": "801-376-3202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 WASHINGTON AVE # 260.02",
"city": "WACO",
"state": "TX",
"postal_code": "767011282",
"telephone_number": "254-265-8893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLDREDGE",
"first_name": "CAMERON",
"middle_name": "TODD",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-06",
"last_updated": "2023-11-06",
"certification_date": "2023-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "13021318-2501",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "39810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
- David William Alexander, M.D.
- Paul R. Alexander, D.D.S.
- Robin Ruth Alford, ST
- Imran Ali-Bandesha, MD
- Erin Elizabeth Allbritton, DDS, MS
- Linda L Allee-Brickey
- Allegiance Mental Health & Wellness Services LLC (Allegiance Counseling)
- Bruce W Allen, PH.D.
- Dannie Michele Allen, COTA
- Janie Carolyn Allen, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.