Waldo Psychological Services LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

WALDO PSYCHOLOGICAL SERVICES LLC

Practice address

3904 SW Windsong Dr
Lees Summit, MO 64082-4051

Phone

(660) 596-2400

NPI assigned

May 3, 2007

Last updated

Aug 27, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan Waldo, PHDNPI 1174697338

Title

President

Phone

(660) 596-2400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Lauderdale Waldo, PH.D.

  • Psychologist
  • Lee's Summit, MO
  • NPI 1174697338
  Medicare reassignment NPD Authorized official
• Marsha Jane Kranichfield, LCSW

  • Clinical Social Worker
  • Sedalia, MO
  • NPI 1891056354
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1013139203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653021547",
            "telephone_number": "660-826-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 SW WINDSONG DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824051",
            "telephone_number": "660-596-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDO PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "WALDO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "660-596-2400",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26423017",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-4590)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0573)
• Wal-Mart Stores East, LP (Walmart Vision Center 30-4590)
• Wal-Mart Stores East, LP (Vision Center 30-0573)
• Amy Diane Wald, FNP-C
• Susan Lauderdale Waldo, PH.D.
• Walgreen Co (Walgreens #10461)
• Walgreen Co (Walgreens #02450)
• Walgreen Co (Walgreens #04182)
• Jeffrey Brent Walker, RN

• Psychologist in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.