Active NPI
Mary Ann Cotten, PH.D.
- Clinical Psychologist
- Granbury, TX
National Provider Identifier
1730190752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0791
- Practice address
- 201 E Pearl St Ste C-208
Granbury, TX 76048-2177 - Phone
- (817) 573-5891
- Fax
- (817) 732-8015
- NPI assigned
- Aug 11, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0791 | NM | Primary |
Addresses
Primary practice location
201 E Pearl St Ste C-208
Granbury, TX 76048-2177
Mailing address
PO Box 2458
Granbury, TX 76048-7458
Phone (817) 573-5891
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 433837777 | Medicaid | NM | |
| 0966426-05 | Medicaid | TX | |
| 1730190752 | Other | TX | NPI |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
201 E Pearl St
Suite C 208
Granbury, TX 76048-2177
Phone (817) 573-5891
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24906 | TX | MD | Speech-Language Pathologist |
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": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639612800000",
"number": "1730190752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2458",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760487458",
"telephone_number": "817-573-5891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 E PEARL ST STE C-208",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760482177",
"telephone_number": "817-573-5891",
"fax_number": "817-732-8015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTTEN",
"first_name": "MARY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2021-12-16",
"certification_date": "2021-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NM",
"license": "0791",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "433837777",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0966426-05",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1730190752",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Granbury, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.