Individual provider Active NPI

Vicki H Thomas, PHD

  • Clinical Psychologist
  • El Paso, TX
National Provider Identifier
1669400578
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
38560 Issued in TX
Practice address
4615 Alameda Ave
El Paso, TX 79905-2702
Phone
(915) 215-5850
Fax
(915) 215-8657
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 684 NM
Clinical Psychologist 103TC0700X 38560 TX Primary

Addresses

Primary practice location

4615 Alameda Ave
El Paso, TX 79905-2702

Mailing address

440 Raynolds St
El Paso, TX 79905-1613
Phone (915) 215-4480

Other identifiers 1

IdentifierTypeStateIssuer
Q5936MedicaidNM

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

LicenseStateTypeSpecialty
38560TXMDGeneral Practice Dentistry
684NMMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Odessa PastSince Aug 23, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1669400578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 RAYNOLDS ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051613",
            "telephone_number": "915-215-4480",
            "fax_number": "915-215-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 ALAMEDA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052702",
            "telephone_number": "915-215-5850",
            "fax_number": "915-215-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "VICKI",
        "middle_name": "H",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NM",
            "license": "684",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q5936",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.