Active NPI
Mollimichelle Kay Cabeldue, PH.D
- Clinical Psychologist
- Austin, TX
National Provider Identifier
1770040578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 38713
- Practice address
- 5900 Balcones Drive
Suite 100
Austin, TX 78731 - Phone
- (512) 759-8680
- NPI assigned
- Feb 27, 2019
- Last updated
- Aug 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1637 | LA | |
| Clinical Psychologist | 103TC0700X | 38713 | TX | Primary |
| Forensic Psychologist | 103TF0200X | PSY.0005808 | CO |
Addresses
Primary practice location
5900 Balcones Drive
Suite 100
Austin, TX 78731
Mailing address
2110 W Slaughter LN Ste 107
Austin, TX 78748-5978
Phone (512) 759-8680
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 11, 2022 through Apr 11, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY.0005808 | CO | MD | Forensic Psychologist |
| 1637 | LA | MD | Chiropractor |
| 38713 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660176000000",
"number": "1770040578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2110 W SLAUGHTER LN STE 107",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787485978",
"telephone_number": "512-759-8680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 BALCONES DRIVE",
"address_2": "SUITE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78731",
"telephone_number": "512-759-8680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CABELDUE",
"first_name": "MOLLIMICHELLE",
"middle_name": "KAY",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-27",
"last_updated": "2022-08-11",
"certification_date": "2022-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "LA",
"license": "1637",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "38713",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CO",
"license": "PSY.0005808",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.