Individual provider Active NPI

William C. Prince, PSY.D.

  • Prescribing (Medical) Psychologist
  • Las Cruces, NM
National Provider Identifier
1912006024
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
PSY-2025-0107 Issued in NM
Practice address
1635 S Don Roser Dr
Las Cruces, NM 88011
Phone
(323) 804-3590
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY22883 CA
Clinical Psychologist 103TC0700X PSY1675 NM
Prescribing (Medical) Psychologist 103TP0016X PSY-2025-0107 NM Primary

Addresses

Primary practice location

1635 S Don Roser Dr
Las Cruces, NM 88011

Mailing address

150 The Promenade N Unit 515
Long Beach, CA 90802-4757
Phone (323) 804-3590

Other practice location 1

17777 Center Court Dr N Ste 600
Cerritos, CA 90703-8575
Phone (323) 804-3590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20240523001402 NM Practitioner - Clinical Psychologist 8224470117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inetmed RX2 Inc.Group PAC ID 2062796709, 7 clinicians

Practice addresses (Care Compare)

1635 S Don Roser Dr
Las Cruces, NM 88011-4550
Phone (575) 636-2506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY22883CAMDClinical Psychologist
PSY1675NMMDClinical Psychologist
PSY-2025-0107NMMDPrescribing (Medical) Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Inetmed RX2 Inc. Clinical CurrentSince Apr 1, 2024 Accepting new patients

Locations

1635 S Don Roser Dr
Ste A
Las Cruces, NM 88011
Phone (575) 635-2506

1635 S Don Roser Dr
Las Cruces, NM 88011
Phone (575) 522-1241

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1912006024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 THE PROMENADE N UNIT 515",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024757",
            "telephone_number": "323-804-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 S DON ROSER DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88011",
            "telephone_number": "323-804-3590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17777 Center Court Dr N Ste 600",
            "address_purpose": "LOCATION",
            "city": "Cerritos",
            "state": "CA",
            "postal_code": "907038575",
            "country_code": "US",
            "telephone_number": "323-804-3590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "WILLIAM",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22883",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "PSY1675",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NM",
            "license": "PSY-2025-0107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.