Active NPI
Carolyn Lee Huddleston, PHD
- Clinical Psychologist
- Liberal, KS
National Provider Identifier
1932176278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP598
- Practice address
- 316 W 7TH St
Liberal, KS 67901 - Phone
- (620) 626-4508
- Fax
- (620) 626-4508
- NPI assigned
- Mar 7, 2006
- Last updated
- Dec 9, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP598 | KS | Primary |
Addresses
Primary practice location
316 W 7TH St
Liberal, KS 67901
Mailing address
316 W 7TH St
Liberal, KS 67901
Phone (620) 626-4508
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004471 | Other | KS | BLUE CROSS BLUE SHIELD |
| 100842710A | Medicaid | OK | |
| 100238670A | Medicaid | KS |
Other names 1
- Ms. Carolyn Lee Fraps
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP598 | KS | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291852800000",
"number": "1932176278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 W 7TH ST",
"city": "LIBERAL",
"state": "KS",
"postal_code": "67901",
"telephone_number": "620-626-4508",
"fax_number": "620-626-4508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 W 7TH ST",
"city": "LIBERAL",
"state": "KS",
"postal_code": "67901",
"telephone_number": "620-626-4508",
"fax_number": "620-626-4508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDDLESTON",
"first_name": "CAROLYN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-07",
"last_updated": "2010-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "LP598",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "004471",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100842710A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100238670A",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CAROLYN",
"last_name": "FRAPS",
"middle_name": "LEE",
"prefix": "MS.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Liberal, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.