Individual provider Active NPI

Keila Santos- Crespo

  • Clinical Psychologist
  • Cleburne, TX
National Provider Identifier
1841612249
Registry record updated Sep 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
38487 Issued in TX
Practice address
904 N Main St Ste C
Cleburne, TX 76033-3803
Phone
(939) 645-1555
Fax
(817) 558-7566
NPI assigned
Jan 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 38487 TX Primary

Addresses

Primary practice location

904 N Main St Ste C
Cleburne, TX 76033-3803

Mailing address

PO Box 241
Keene, TX 76059-0241
Phone (939) 645-1555

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
I20200720001224 TX Practitioner - Clinical Psychologist 1850715202 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

115 S Main St
Suite 202
Cleburne, TX 76033-5501
Phone (939) 645-1555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38487TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Medical Center CurrentSince Feb 10, 2026 Accepting new patients
Healing Path Psychological Services Clinical CurrentSince Jun 2, 2020 Accepting new patients
Cook Children'S Medical Center CurrentSince Feb 10, 2026 Accepting new patients
Tara Mitchell, LCSW PastSince Nov 1, 2020 Accepting new patients

Locations

1011 Granbury St
Cleburne, TX 76033
Phone (817) 645-3328

904 N Main St
Ste C
Cleburne, TX 76033
Phone (817) 645-3328

115 S Main St
Ste 202
Cleburne, TX 76033
Phone (939) 645-1555

1500 Cooper St
Ft Worth, TX 76104
Phone (682) 885-2500

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1390176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758326400000",
    "number": "1841612249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241",
            "city": "KEENE",
            "state": "TX",
            "postal_code": "760590241",
            "telephone_number": "939-645-1555",
            "fax_number": "817-755-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 N MAIN ST STE C",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760333803",
            "telephone_number": "939-645-1555",
            "fax_number": "817-558-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS- CRESPO",
        "first_name": "KEILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-20",
        "last_updated": "2025-09-20",
        "certification_date": "2025-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

Verify at the official NPI Registry.