M. Theresa Emerson, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

22851 Issued in TX

Practice address

6609 Sanger Ave
Waco, TX 76710-4252

Phone

(254) 776-3632

Fax

(254) 776-8181

NPI assigned

Aug 18, 2005

Last updated

Jul 10, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1942292719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21594",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767021594",
            "telephone_number": "254-776-3632",
            "fax_number": "254-776-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 SANGER AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104252",
            "telephone_number": "254-776-3632",
            "fax_number": "254-776-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "M.",
        "middle_name": "THERESA",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "22851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00J50P",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Waco, TX
• Providers in Waco, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.