NPIMap

Organization Active NPI

Mission Psychological Center, P.a.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mission, TX
National Provider Identifier
1730219007
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MISSION PSYCHOLOGICAL CENTER, P.A.
Practice address
2504 N Conway Ave
Mission, TX 78574-2349
Phone
(956) 519-9000
Fax
(956) 519-7722
NPI assigned
Mar 6, 2007
Last updated
Aug 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Barry D. BergerNPI 1780677575
Title
President
Phone
(956) 519-9000

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2504 N Conway Ave
Mission, TX 78574-2349

Mailing address

2504 N Conway Ave
Mission, TX 78574-2349
Phone (956) 519-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050129000068 TX Part B Supplier - Clinic/Group Practice 5799735502 Receives reassigned benefits from 1 practitioner
Practice locations: Mission, TX

National Provider Directory

National Provider Directory

Locations

2504 N Conway Ave
Mission, TX 78574
Phone (856) 519-9000

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1730219007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 N CONWAY AVE",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785742349",
            "telephone_number": "956-519-9000",
            "fax_number": "956-519-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 N CONWAY AVE",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785742349",
            "telephone_number": "956-519-9000",
            "fax_number": "956-519-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION PSYCHOLOGICAL CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-519-9000"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.