Organization Active NPI

Blue Star Psychology & Consulting, PLLC

  • Rehabilitation Psychologist
  • Plano, TX
National Provider Identifier
1679162564
Registry record updated May 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
Legal business name
BLUE STAR PSYCHOLOGY & CONSULTING, PLLC
Practice address
5055 W Park Blvd Ste 400
Plano, TX 75093-2590
Phone
(940) 290-2565
NPI assigned
Jan 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2022

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

Authorized official

Name
Dr. Ursula Alford, PH.D.NPI 1992023105
Title
President
Phone
(940) 290-2565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TR0400X Primary

Addresses

Primary practice location

5055 W Park Blvd Ste 400
Plano, TX 75093-2590

Mailing address

5055 W Park Blvd Ste 400
Plano, TX 75093-2590
Phone (940) 290-2565

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL secureurl.simplepractice. Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220322000143 TX Part B Supplier - Clinic/Group Practice 7012302466 Receives reassigned benefits from 5 practitioners
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Locations

11625 Custer Rd
Ste 110306
Frisco, TX 75035

419 N Commerce St
Gainesville, TX 76240
Phone (940) 290-2565

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653091200000",
    "number": "1679162564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 W PARK BLVD STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750932590",
            "telephone_number": "940-290-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 W PARK BLVD STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750932590",
            "telephone_number": "940-290-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE STAR PSYCHOLOGY & CONSULTING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-14",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-21",
        "status": "A",
        "authorized_official_last_name": "ALFORD",
        "authorized_official_first_name": "URSULA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-290-2565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "secureurl.simplepractice.",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5055 W Park Blvd Ste 400",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750932590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.