Organization Active NPI

Winsted Psychological Services, PLLC

  • Psychologist
  • Longview, TX
National Provider Identifier
1811197080
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
30903 Issued in TX
Legal business name
WINSTED PSYCHOLOGICAL SERVICES, PLLC
Practice address
414 N Green Street
Longview, TX 75601
Phone
(903) 238-9050
Fax
(903) 238-9051
NPI assigned
Jul 24, 2007
Last updated
Mar 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Authorized official

Name
Dr. Donald Winsted III, PH.D.
Title
Manager
Phone
(903) 238-9050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 30903 TX Primary

Addresses

Primary practice location

414 N Green Street
Longview, TX 75601

Mailing address

414 N Green Street
Longview, TX 75601
Phone (903) 238-9050

Other identifiers 2

IdentifierTypeStateIssuer
095440604MedicaidTX
202200602MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080404000184 TX Part B Supplier - Clinic/Group Practice 3971680737 Practice locations: Longview, TX

National Provider Directory

National Provider Directory

Locations

103 Woodbine Pl
#A
Longview, TX 75601
Phone (903) 212-7788

107 Community Blvd
Ste 13
Longview, TX 75605
Phone (903) 238-9050

414 N Green St
Longview, TX 75601
Phone (903) 238-9050

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1811197080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 N GREEN STREET",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75601",
            "telephone_number": "903-238-9050",
            "fax_number": "903-238-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 N GREEN STREET",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75601",
            "telephone_number": "903-238-9050",
            "fax_number": "903-238-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINSTED PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "WINSTED",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "903-238-9050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "30903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095440604",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202200602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.