Wavelengths Psychology, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

WAVELENGTHS PSYCHOLOGY, PC

Practice address

4770 Sunrise Hwy
Suite 105
Massapequa Park, NY 11762-2911

Phone

(800) 871-5491

Fax

(800) 871-5491

NPI assigned

Feb 5, 2016

Organization subpart

No

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

Authorized official

Name

Sharon Grand, PHD

Title

Owner

Phone

(800) 871-5491

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1013375906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 SUNRISE HWY",
            "address_2": "SUITE 105",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622911",
            "telephone_number": "800-871-5491",
            "fax_number": "800-871-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 SUNRISE HWY",
            "address_2": "SUITE 105",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622911",
            "telephone_number": "800-871-5491",
            "fax_number": "800-871-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVELENGTHS PSYCHOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-12-12",
        "status": "A",
        "authorized_official_last_name": "GRAND",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-871-5491",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Walsh, RN
• Abra Joy Walter, PSY.D.
• Eric J Walter, PSY.D.
• Jyy-Fen Wang, MASTER OF SCIENCE
• Denise Watson, SLP
• Laura Jean Weigand, PTA
• Roberta Whitefield
• Janet Whyte
• Janet Widerspan, M.D.
• Derrick Williams

• Clinical Psychologist in Massapequa Park, NY
• Providers in Massapequa Park, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.