Provider Demographics
NPI:1164145769
Name:TEXAS CHILD PSYCHOLOGICAL SERVICES, PLLC
Entity type:Organization
Organization Name:TEXAS CHILD PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP, NCSP
Authorized Official - Phone:817-381-6298
Mailing Address - Street 1:1010 LAND CREEK CV STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6874
Mailing Address - Country:US
Mailing Address - Phone:817-381-6298
Mailing Address - Fax:817-381-6298
Practice Address - Street 1:1010 LAND CREEK CV STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6874
Practice Address - Country:US
Practice Address - Phone:737-381-0415
Practice Address - Fax:737-381-0415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty