Individual provider Active NPI

Cindy Lee Kidner, PH.D.

  • Psychologist
  • Richardson, TX
National Provider Identifier
1760920862
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35106 Issued in TX
Practice address
1701 Gateway Blvd Ste 431
Richardson, TX 75080-3627
Phone
(972) 807-2525
NPI assigned
Feb 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35106 TX Primary

Addresses

Primary practice location

1701 Gateway Blvd Ste 431
Richardson, TX 75080-3627

Mailing address

1701 Gateway Blvd Ste 431
Richardson, TX 75080-3627
Phone (972) 807-2525

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
I20170823000328 TX Practitioner - Clinical Psychologist 3476825639 Practice locations: Richardson, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1701 Gateway Blvd
Suite 431
Richardson, TX 75080-3627
Phone (972) 807-2525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35106TXMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1760920862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 GATEWAY BLVD STE 431",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803627",
            "telephone_number": "972-807-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 GATEWAY BLVD STE 431",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803627",
            "telephone_number": "972-807-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDNER",
        "first_name": "CINDY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "35106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.