Individual provider Active NPI

Reda G Rasco, PSY. D.

  • Clinical Psychologist
  • Wichita Falls, TX
National Provider Identifier
1730224262
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
34999 Issued in TX
Practice address
2934 Kemp Blvd
Wichita Falls, TX 76308-1017
Phone
(940) 691-1899
Fax
(940) 691-3423
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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 34999 TX Primary
Counselor 101Y00000X 19361 TX

Addresses

Primary practice location

2934 Kemp Blvd
Wichita Falls, TX 76308-1017

Mailing address

4722 Taft Blvd Ste 2
Wichita Falls, TX 76308-4800
Phone (940) 691-1899

Other identifiers 2

IdentifierTypeStateIssuer
84576LOtherTXBLUE CROSS ID NUMBER
171788601MedicaidTX

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
I20110816000436 TX Practitioner - Clinical Psychologist 1759550395 Reassigns benefits to 1 organization
Practice locations: Wichita Falls, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Taft Counseling Center IncGroup PAC ID 1254581564, 8 clinicians

Practice addresses (Care Compare)

2934 Kemp Blvd
Wichita Falls, TX 76308-1017
Phone (940) 691-1899

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19361TXMDCounselor
34999TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Madden Counseling Past Accepting new patients
Allergy Center, P.a. Past Accepting new patients

Organizations & group practices 3

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1730224262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4722 TAFT BLVD STE 2",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763084800",
            "telephone_number": "940-691-1899",
            "fax_number": "940-691-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2934 KEMP BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763081017",
            "telephone_number": "940-691-1899",
            "fax_number": "940-691-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASCO",
        "first_name": "REDA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "34999",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "19361",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID NUMBER",
            "identifier": "84576L",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171788601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.