TEXAS TECH UNIVERSITY PSYCHOLOGY CLINIC (NPI# 1205044740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205044740 |
Entity Type | Organization |
Organization Name | TEXAS TECH UNIVERSITY PSYCHOLOGY CLINIC |
Practice Address |
18th Street and Boston Avenue Lubbock TX 79409 |
Mailing Address |
Po Box 42051 Lubbock TX 79409-2051 |
Practice Telephone | 8067423737 |
Practice Fax Number | 8067423799 |
Mailing Telephone | 8067423737 |
Mailing Fax Number | 8067423799 |
Enumeration Date | 2007-05-18 |
Last Update Date | 2020-08-22 |
Authorized Official Name | DR. STEPHEN WRIGHT COOK (CLINIC DIRECTOR) |
Authorized Official Telephone | 8067423737 |
Authorized Official Credential | PHD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 103T00000X | Psychologist | 23874 | TX | Behavioral Health & Social Service Providers |
N | 103T00000X | Psychologist | 23791 | TX | Behavioral Health & Social Service Providers |
N | 103T00000X | Psychologist | 32461 | TX | Behavioral Health & Social Service Providers |
Y | 103T00000X | Psychologist | 25048 | TX | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | BLUE CROSS BLUE SHIELD | 0012KD | 01 |
TX | INTERFACE EAP | 04238.4 | 01 |
TX | COMP CARE FIRST CARE | TEXAS0004 TEXAS 0011 | 01 |
Street Address |
18TH STREET AND BOSTON AVENUE |
City | LUBBOCK |
State | TX |
Zip Code | 79409 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841828126 | Luke Malone | Student in an Organized Health Care Education/Training Program | 2503 Mac Davis Lane, Lubbock, TX 79409 | 2020-03-31 |
1023563889 | Austin P. Wade | Psychologist | 1003 Flint Ave, Lubbock, TX 79409 | 2016-08-23 |
1104221928 | Amanda Dorsten | Specialist/Technologist | 6216 66th St, Lubbock, TX 79409 | 2014-10-23 |
1124420427 | Chrystal Jansz | Behavioral Analyst | 2902 18th Street, Lubbock, TX 79409 | 2014-09-18 |
1578682175 | Stephen Michael Pincock | Specialist/Technologist | 6th & Red Raider Ave., Atf Box 43021, Lubbock, TX 79409 | 2007-03-28 |
1871636738 | Texas Tech Student Health Pharmacy | Pharmacy | 1003 Flint Ave., Lubbock, TX 79409 | 2007-02-14 |
1871996421 | Jason C Cohen | Behavioral Analyst | 2902 18th Street, Lubbock, TX 79409 | 2014-09-26 |
1710389317 | Texas Tech University | Behavioral Analyst | 2902 18th Street, Lubbock, TX 79409 | 2014-09-25 |
1215339452 | Wesley H Dotson | Behavioral Analyst | 2902 18th Street, Lubbock, TX 79409 | 2014-09-18 |
1265643654 | Sara Ann Smock | Marriage & Family Therapist | Applied and Professional Studies,broadway and Akron St., Rm 260, Human Sciences, Box 41162, Lubbock, TX 79409-1162 | 2007-05-25 |
Find all providers in zip 79409 |
Taxonomy Code | 103T00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
Notes: Source: American Psychological Association [1/1/2007: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336786870 | Bailey P Tackett | Psychologist | 2024 82nd St Unit 103, Lubbock, TX 79423-4343 | 2019-12-03 |
1992215503 | Sharla Boyd, Ph.d., Pllc | Psychologist | 6824 Wayne Ave Ste 1, Lubbock, TX 79424-1649 | 2017-10-10 |
1760917371 | Discovery Medical Network Telehealth, LLC | Psychologist | 2950 50th St, Lubbock, TX 79413-4326 | 2017-04-21 |
1558806729 | Elizabeth Eliot Dennard | Psychologist | 5502 58th St Ste 600, Lubbock, TX 79414-2087 | 2016-12-27 |
1942679535 | Shena Smith | Psychologist | 2034 82nd St Unit 103, Lubbock, TX 79423 | 2015-09-24 |
1316121320 | Michael Daniel Gomez | Psychologist | 6610 Quaker Ave, Lubbock, TX 79413 | 2007-12-27 |
1699983098 | Richard Scotten Wampler | Psychologist | Marriage and Family Therapy, Aps, Box 41162, Texas Tech University, Lubbock, TX 79409-1162 | 2007-05-18 |
1154465409 | George Gary Walker | Psychologist | 5120 29th Dr Ste C, Lubbock, TX 79407-2612 | 2007-02-19 |
1013060946 | Patrick David Randolph | Psychologist | 5147 69th St Ste D, Lubbock, TX 79424-1646 | 2007-01-22 |
1093869695 | Stephen Cook | Psychologist | 18th & Boston, #111a, Lubbock, TX 79409-2051 | 2007-01-22 |
Find all providers in LUBBOCK |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.