Active NPI
Katherine R McKenzie-Meredith, PSY.D.
- Clinical Psychologist
- Dallas, TX
National Provider Identifier
1972841542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 36175
- Practice address
- 411 N Washington Ave
Suite 5000
Dallas, TX 75246-1713 - Phone
- (214) 818-2536
- Fax
- (214) 818-8466
- NPI assigned
- Jan 16, 2013
- Last updated
- Jan 16, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 36175 | TX | |
| Psychologist | 103T00000X | 36175 | TX | |
| Clinical Psychologist | 103TC0700X | 36175 | TX | Primary |
| Rehabilitation Psychologist | 103TR0400X | 36175 | TX | |
| Health Psychologist | 103TH0004X | 36175 | TX |
Addresses
Primary practice location
411 N Washington Ave
Suite 5000
Dallas, TX 75246-1713
Mailing address
411 N Washington Ave
Suite 5000
Dallas, TX 75246-1713
Phone (214) 818-2536
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36175 | TX | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358294400000",
"number": "1972841542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 N WASHINGTON AVE",
"address_2": "SUITE 5000",
"city": "DALLAS",
"state": "TX",
"postal_code": "752461713",
"telephone_number": "214-818-2536",
"fax_number": "214-818-8466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 N WASHINGTON AVE",
"address_2": "SUITE 5000",
"city": "DALLAS",
"state": "TX",
"postal_code": "752461713",
"telephone_number": "214-818-2536",
"fax_number": "214-818-8466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENZIE-MEREDITH",
"first_name": "KATHERINE",
"middle_name": "R",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-16",
"last_updated": "2013-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TX",
"license": "36175",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "36175",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "36175",
"primary": true
},
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "TX",
"license": "36175",
"primary": false
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "TX",
"license": "36175",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.