Active NPI
Mandee Wilkinson, MA, LPA, LSSP, NCSP
- Psychologist
- Southlake, TX
National Provider Identifier
1831810027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 38526
- Practice address
- 1340 N White Chapel Blvd Ste 130
Southlake, TX 76092-4327 - Phone
- (817) 381-6569
- NPI assigned
- Sep 7, 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 38526 | TX | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 38526 | TX | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 38526 | TX | |
| School Psychologist | 103TS0200X | 33485 | TX | |
| Psychologist | 103T00000X | 38526 | TX | Primary |
Addresses
Primary practice location
1340 N White Chapel Blvd Ste 130
Southlake, TX 76092-4327
Mailing address
1340 N White Chapel Blvd Ste 130
Southlake, TX 76092-4327
Phone (936) 714-1985
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33485 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662508800000",
"number": "1831810027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 N WHITE CHAPEL BLVD STE 130",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760924327",
"telephone_number": "936-714-1985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 N WHITE CHAPEL BLVD STE 130",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760924327",
"telephone_number": "817-381-6569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKINSON",
"first_name": "MANDEE",
"credential": "MA, LPA, LSSP, NCSP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-07",
"last_updated": "2022-09-07",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "TX",
"license": "38526",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "TX",
"license": "38526",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "TX",
"license": "38526",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "TX",
"license": "33485",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "38526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.