Richard L Wakefield, PHD
Individual provider Active NPI Psychologist · Ball, LA
NPI 1003845843 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003845843
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 754 (LA)
- Practice address
- 5529 Monroe Hwy
Ball, LA 71405-3356 - Phone
- (318) 641-0444
- NPI assigned
- Jul 2, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 754 | LA | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 754 | LA | Yes |
Addresses
Primary practice location
5529 Monroe Hwy
Ball, LA 71405-3356
Mailing address
5529 Monroe Hwy
Ball, LA 71405-3356
Phone (318) 641-0444
Other providers in Ball, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.