Active NPI
Stacey L. Shipley, CLINICAL PSYCHOLOGY
- Psychologist
- Vernon, TX
National Provider Identifier
1710196795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 32024
- Practice address
- 4730 College Dr
Vernon, TX 76384-4009 - Phone
- (940) 552-4055
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 32024 | TX | Primary |
Addresses
Primary practice location
4730 College Dr
Vernon, TX 76384-4009
Mailing address
4730 College Dr
Vernon, TX 76384-4009
Phone (940) 552-4055
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32024 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710196795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4730 COLLEGE DR",
"city": "VERNON",
"state": "TX",
"postal_code": "763844009",
"telephone_number": "940-552-4055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4730 COLLEGE DR",
"city": "VERNON",
"state": "TX",
"postal_code": "763844009",
"telephone_number": "940-552-4055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIPLEY",
"first_name": "STACEY",
"middle_name": "L.",
"credential": "CLINICAL PSYCHOLOGY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "32024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernon, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.