Emily Rademan, PSY.D

Individual provider Active NPI Clinical Psychologist · Springtown, TX

NPI 1861746729 · NPPES record last updated Nov 3, 2024

Key facts

NPI
1861746729
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PSY.0004289 (CO)
Practice address
156 Spring Meadow Dr
Springtown, TX 76082-1140
Phone
(719) 357-6462
Fax
(719) 203-4485
NPI assigned
Oct 30, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2012037392MOMDProfessional Counselor
PSY.0004289COMDClinical Psychologist
40355TXMDCase Manager/Care Coordinator

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0004289 CO Yes
Professional Counselor 101YP2500X 2012037392 MO

Addresses

Primary practice location

156 Spring Meadow Dr
Springtown, TX 76082-1140

Mailing address

156 Spring Meadow Dr
Springtown, TX 76082-1140
Phone (719) 357-6462

Other providers in Springtown, TX

All providers in Springtown, TX · Clinical Psychologist in Texas

Sources for this page

Verify at the official NPI Registry.