Alphapsych, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

32262 Issued in TX

Legal business name

ALPHAPSYCH, PLLC

Practice address

6612 N Riverside Dr
Suite 130
Fort Worth, TX 76137-6663

Phone

(817) 232-8877

NPI assigned

Apr 29, 2013

Last updated

Jul 2, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer R Burgess, PSYDNPI 1245369503

Title

Managing Psychologist

Phone

(817) 559-4045

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Jennifer R Burgess, PSYD

  • Psychologist
  • Fort Worth, TX
  • NPI 1245369503
  NPD (past) Authorized official

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1730524174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6612 N RIVERSIDE DR",
            "address_2": "SUITE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761376663",
            "telephone_number": "817-232-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6612 N RIVERSIDE DR",
            "address_2": "SUITE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761376663",
            "telephone_number": "817-232-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHAPSYCH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGING PSYCHOLOGIST",
        "authorized_official_telephone_number": "817-559-4045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "32262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.