PRISTINE BEHAVIORAL THERAPY (NPI# 1134762636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134762636 |
| Entity Type | Organization |
| Organization Name | PRISTINE BEHAVIORAL THERAPY |
| Practice Address |
715 N Fielder Rd Arlington TX 76012-4695 |
| Practice Telephone | 8179620409 |
| Practice Fax Number | 8179002475 |
| Mailing Telephone | 8179620409 |
| Mailing Fax Number | 8179002475 |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2019-10-28 |
| Authorized Official Name | TRALICA CLEWIS (CREDENTIAL/BILLING) |
| Authorized Official Telephone | 8179620409 |
| Authorized Official Credential | MA, BSN, COM |
| Is Organization Subpart | Y |
| Parent Organization Name | PRISTINE TRANSLATIONS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| North Tx Behavioral Clinic | Doing Business As Name - Organization |
| Street Address |
715 N FIELDER RD |
| City | ARLINGTON |
| State | TX |
| Zip Code | 76012-4695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780734582 | Edward Earl Rotan Jr. | Dermatology | 715 N Fielder Rd, Arlington, TX 76012-4695 | 2007-01-12 |
| 1447867106 | Eunice Kamanthe Makau | Nurse Practitioner | 715 N Fielder Rd, Arlington, TX 76012-4695 | 2020-09-28 |
| 1801435565 | Titilope Afusat Lawal-johnson | Psychiatry & Neurology | 715 N Fielder Rd, Arlington, TX 76012-4695 | 2019-12-29 |
| 1295376945 | Amanda Kate Long | Nurse Practitioner | 715 N Fielder Rd, Arlington, TX 76012-4695 | 2019-10-03 |
| 1023676061 | Lillian Kenani King | Nurse Practitioner | 715 N Fielder Rd, Arlington, TX 76012-4695 | 2019-06-04 |
| 1528623469 | Shelley Durham Do Pa | Family Medicine | 715 N Fielder Rd, Arlington, TX 76012-4695 | 2019-05-06 |
| 1912560954 | Sussan Chinyere Nwogwugwu | Nurse Practitioner | 715 N Fielder Rd, Arlington, TX 76012-4695 | 2019-04-16 |
| 1013475979 | Primecare Family Practice | Nurse Practitioner | 715 N Fielder Rd, Arlington, TX 76012-4695 | 2019-03-08 |
| 1932440021 | Maria Mosomi | Nurse Practitioner | 715 N Fielder Rd, Arlington, TX 76012-4695 | 2013-03-14 |
| 1215217351 | Maryline Ongangi | Nurse Practitioner | 715 N Fielder Rd, Arlington, TX 76012-4695 | 2011-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366073736 | Britney Beard | Counselor | 715 N Fielder Rd Ste A, Arlington, TX 76012 | 2020-02-04 |
| 1932762531 | Devin Austin Deloe | Speech-Language Pathologist | Arlington Villas, 2601 W Randol Mill Rd., Arlington, TX 76012 | 2019-04-18 |
| 1275000135 | Soh of Texas Samson Liu Pllc | Dentist | 1625 Pecan Dr, Arlington, TX 76012 | 2018-10-30 |
| 1295200749 | Eness, Inc. | In Home Supportive Care | 1321 West Randol Mill Road, #108, Arlington, TX 76012 | 2018-10-11 |
| 1073967626 | Maya Alex Kuriakose | Obstetrics & Gynecology | 1001 N. Waldrop, Suite 505, Arlington, TX 76012 | 2016-04-20 |
| 1710359971 | Amir Izaddoust | Dentist | 723 N. Fielder Rd, Suite E, Dallas, TX 76012 | 2015-10-28 |
| 1639553738 | Alicia Rider | Specialist/Technologist | 1507 Cherokee Szt, Arlington, TX 76012 | 2015-07-17 |
| 1508274614 | Neurodiagnostic Consultants, L.L.C. | Specialist | 1102 Orchard Drive, Arlington, TX 76012 | 2014-08-01 |
| 1578974663 | Lan Ngoc Nguyen, Pharm.d.,,llc | Pharmacy | 1102 Orchard Dr., Suite B, Arlington, TX 76012 | 2014-05-12 |
| 1871854471 | Takeisha Jones | Occupational Therapy Assistant | 532 Claire Ct, Arlington, TX 76012 | 2012-05-31 |
| Find all providers in zip 76012 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750980421 | Chad Olle | Psychologist | 1020 N Highland St Unit 817, Arlington, VA 22201-2187 | 2020-10-22 |
| 1467003715 | Kelly Deneen Heinzman | Psychologist | 1101 Wilson Blvd, Arlington, VA 22209-2211 | 2019-09-26 |
| 1932433000 | Konjit Page | Psychologist | 32 Windsor Street, Arlington, MA 02474-5520 | 2009-09-23 |
| 1588850283 | James Gerard Barrett | Psychologist | 12 Teel St, Arlington, MA 02474-5513 | 2007-09-18 |
| 1982798559 | John W Hesley | Psychologist | 6031 Interstate 20 W, Suite 253, Arlington, TX 76017-1084 | 2006-10-03 |
| 1497366124 | Jo Ellyn Walker | Psychologist | 1655 Fort Myer Dr Ste 820, Arlington, VA 22209-3106 | 2020-08-15 |
| 1831405943 | Insight Educational and Psychological Services, LLC | Psychologist | 5620 Sw Green Oaks Blvd, Suite D, Arlington, TX 76017-1160 | 2010-08-26 |
| 1437465788 | Tameka Susberry Miller | Psychologist | 5620 Sw Green Oaks Blvd Ste D, Arlington, TX 76017-1151 | 2010-08-24 |
| 1386801827 | Dana Abernathy Wicker | Psychologist | 2912 Little Rd, Arlington, TX 76016-1725 | 2008-05-21 |
| 1518045582 | Steven Joel Isenberg | Psychologist | 259 Massachusetts Ave, Arlington, MA 02474-8406 | 2006-11-01 |
| Find all providers in ARLINGTON | ||||
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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.