Individual provider Active NPI

Laura Thoreson, PSY.D

  • Clinical Psychologist
  • Cedar Park, TX
National Provider Identifier
1699187906
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
40055 Issued in TX
Practice address
3000 Polar LN Ste 101
Cedar Park, TX 78613-3065
Phone
(844) 824-8775
NPI assigned
May 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 26374 CA
Clinical Psychologist 103TC0700X 40055 TX Primary

Addresses

Primary practice location

3000 Polar LN Ste 101
Cedar Park, TX 78613-3065

Mailing address

PO Box 2631
Guasti, CA 91743-2631

Other practice location 1

11100 4th St Apt G301
Rancho Cucamonga, CA 91730-0908
Phone (626) 688-0746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250410001927 TX Practitioner - Clinical Psychologist 2668690892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

3000 Polar LN
Suite 101
Cedar Park, TX 78613-3065
Phone (844) 824-8775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
26374CAMDMassage Therapist
40055TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC Clinical CurrentSince Mar 10, 2025 Accepting new patients

Locations

3000 Polar Ln
Ste 101
Cedar Park, TX 78613
Phone (512) 201-4006

308 S Friendswood Dr
Ste 200
Friendswood, TX 77546
Phone (253) 346-0386

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

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": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1699187906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2631",
            "city": "GUASTI",
            "state": "CA",
            "postal_code": "917432631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 POLAR LN STE 101",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786133065",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 4th St Apt G301",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917300908",
            "country_code": "US",
            "telephone_number": "626-688-0746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORESON",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "26374",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "40055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.