Active NPI
Stacy Ellane Shields, PHD
- Psychologist
- Houston, TX
National Provider Identifier
1689306078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 37787
- Practice address
- 650 N Sam Houston Pkwy E Ste 516
Houston, TX 77060-5915 - Phone
- (832) 299-4146
- NPI assigned
- Jun 26, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 37787 | TX | Primary |
Addresses
Primary practice location
650 N Sam Houston Pkwy E Ste 516
Houston, TX 77060-5915
Mailing address
650 N Sam Houston Pkwy E Ste 516
Houston, TX 77060-5915
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 |
|---|---|---|---|
| 37787 | TX | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Psychologist | Current | Accepting new patients |
Interoperability endpoints
- stacyshields@tdh.allscriptsdirect.net
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.
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
Psychologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1689306078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 N SAM HOUSTON PKWY E STE 516",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770605915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 N SAM HOUSTON PKWY E STE 516",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770605915",
"telephone_number": "832-299-4146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "STACY",
"middle_name": "ELLANE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-26",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "37787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.