Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Marietta Baccus Richard, PHD

Individual provider Clinical Psychologist · NPI 1699950782

Dr. Marietta Baccus Richard, PHD is a Clinical Psychologist in Southlake, Texas. Qualified in 1990, 36 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Texas.

Years since qualifying
36
Licensed in
TX
In the registry since
2008
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

1725 E Southlake Blvd Ste 102
Southlake, TX 76092-6457
Phone: (682) 477-4400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 24396 (TX)

Record details

NPI number1699950782
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedJanuary 8, 2008
Last updated in NPPESJune 28, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1990 (36 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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