Stacey Lavoro Rexrode, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35059 Issued in TX

Practice address

1101 Arrow Point Dr
Suite 210
Cedar Park, TX 78613-7737

Phone

(512) 259-0070

Fax

(866) 542-5768

NPI assigned

May 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1770532616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 ARROW POINT DR",
            "address_2": "SUITE 210",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137737",
            "telephone_number": "512-259-0070",
            "fax_number": "866-542-5768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 ARROW POINT DR",
            "address_2": "SUITE 210",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137737",
            "telephone_number": "512-259-0070",
            "fax_number": "866-542-5768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REXRODE",
        "first_name": "STACEY",
        "middle_name": "LAVORO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 6175",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "35059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.