Individual provider Active NPI

Doris Eileen Nevin, PH.D.

  • Prescribing (Medical) Psychologist
  • Lafayette, LA
National Provider Identifier
1902017114
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
321261 Issued in LA
Practice address
1602 W Pinhook Rd Ste 303
Lafayette, LA 70508-3735
Phone
(337) 534-4214
Fax
(337) 484-1405
NPI assigned
May 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1431 NM
Counseling Psychologist 103TC1900X 0810000245 VA
Forensic Psychologist 103TF0200X 0810000245 VA
Prescribing (Medical) Psychologist 103TP0016X PSY-RXP0058 NM
Prescribing (Medical) Psychologist 103TP0016X 321261 LA Primary

Addresses

Primary practice location

1602 W Pinhook Rd Ste 303
Lafayette, LA 70508-3735

Mailing address

305 Live Oak Dr
Lafayette, LA 70503-3903
Phone (540) 354-6174

Other practice location 1

333 NM Highway 528 NE LL 100
Rio Rancho, NM 87124-8712
Phone (540) 354-6174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170623000085 NM Practitioner - Clinical Psychologist 3476501610 Practice locations: Rio Rancho, NM
I20241023003986 NM Practitioner - Psychologist Billing Independently 3476501610 Practice locations: Rio Rancho, NM

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Rio Rancho, NM 87174
Phone (540) 354-6174

PO Box
Suite 45681
Rio Rancho, NM 87174-5681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1431NMMDPsychologist
0810000245VAMDCounseling Psychologist
321261LAMDPrescribing (Medical) Psychologist
PSY-RXP0058NMMDPrescribing (Medical) Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Clinical Associates P.C. Past Accepting new patients
Elton'S Soul to Soul Company PastSince Dec 29, 2019 Accepting new patients
Appalachian Counseling Center PC Past Accepting new patients

Organizations & group practices 3

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": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1902017114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 LIVE OAK DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033903",
            "telephone_number": "540-354-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W PINHOOK RD STE 303",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083735",
            "telephone_number": "337-534-4214",
            "fax_number": "337-484-1405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 NM Highway 528 NE LL 100",
            "address_purpose": "LOCATION",
            "city": "Rio Rancho",
            "state": "NM",
            "postal_code": "871248712",
            "country_code": "US",
            "telephone_number": "540-354-6174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEVIN",
        "first_name": "DORIS",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-28",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "1431",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "VA",
            "license": "0810000245",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "VA",
            "license": "0810000245",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NM",
            "license": "PSY-RXP0058",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "LA",
            "license": "321261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.