Cameron Todd Alldredge, PHD
Individual provider Active NPI Clinical Psychologist · Waco, TX
NPI 1669245114 · NPPES record last updated Nov 6, 2023
Key facts
- NPI
- 1669245114
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 39810 (TX)
- Practice address
- 801 Washington Ave # 260.02
Waco, TX 76701-1282 - Phone
- (254) 265-8893
- NPI assigned
- Nov 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- 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 |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 13021318-2501 | UT | |
| Clinical Psychologist | 103TC0700X | 39810 | TX | Yes |
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
Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.