Individual provider Active NPI

Larry Lynn Hanselka, PHD

  • Clinical Psychologist
  • Dallas, TX
National Provider Identifier
1750615639
Registry record updated Sep 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2-5163 Issued in TX
Practice address
8222 Douglas Ave
Ste. 375
Dallas, TX 75225-5923
Phone
(214) 905-5090
Fax
(214) 905-1998
NPI assigned
Sep 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2-5163 TX Primary

Addresses

Primary practice location

8222 Douglas Ave
Ste. 375
Dallas, TX 75225-5923

Mailing address

302 Rosemary LN
Euless, TX 76039-7925
Phone (817) 857-1007

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2-5163TXMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253836800000",
    "number": "1750615639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 ROSEMARY LN",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760397925",
            "telephone_number": "817-857-1007",
            "fax_number": "214-905-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8222 DOUGLAS AVE",
            "address_2": "STE. 375",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752255923",
            "telephone_number": "214-905-5090",
            "fax_number": "214-905-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSELKA",
        "first_name": "LARRY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-25",
        "last_updated": "2009-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "2-5163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; 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.