Jonathan E Whalen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

376 Issued in ND

Practice address

2808 17TH Ave S
Grand Forks, ND 58201-4010

Phone

(701) 746-8376

Fax

(701) 746-9872

NPI assigned

Jul 4, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lipp Carlson Witucki and Associates LTDGroup PAC ID 2062408701, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lipp, Carlson, Witucki & Associates, LTD

  • Clinical Psychologist
  • Grand Forks, ND
  • NPI 1043316961
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1043240914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 17TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014010",
            "telephone_number": "701-746-8376",
            "fax_number": "701-746-9872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 17TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014010",
            "telephone_number": "701-746-8376",
            "fax_number": "701-746-9872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "JONATHAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Marie Wetterlund
• Kara Brita Wettersten, PH.D.
• Kara Wetzel
• Tyler Wetzel
• Ashton Whalen
• Maria Grace Wharam
• Amanda Wheeler, FNP-C
• Jennifer Whiddon, DPT
• David H. Whitcomb, PH.D.
• White Drug Co of Jamestown Inc (Thrifty White Pharmacy #081)

• Clinical Psychologist in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Clinical Psychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.