Active NPI
Vicki Ann Wahler, LPC
- Psychologist
- Elkhorn, WI
National Provider Identifier
1043313638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2979
- Practice address
- 1 1/2 W Geneva St
Credence Therapy Associates
Elkhorn, WI 53121-1722 - Phone
- (262) 723-3424
- Fax
- (262) 723-8308
- NPI assigned
- Sep 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2979 | IL | Primary |
Addresses
Primary practice location
1 1/2 W Geneva St
Credence Therapy Associates
Elkhorn, WI 53121-1722
Mailing address
1 1/2 W Geneva St
Elkhorn, WI 53121-1722
Phone (262) 723-3424
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11532 | Other | DEAN CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2979 | IL | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Credence Therapy Associates Inc | Past | Accepting new patients | |
| American Behavioral Clinics, SC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatry Physician
- Milwaukee, WI
- NPI 1144313859
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Elkhorn, WI
- NPI 1487648663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043313638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 1/2 W GENEVA ST",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531211722",
"telephone_number": "262-723-3424",
"fax_number": "262-723-8308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 1/2 W GENEVA ST",
"address_2": "CREDENCE THERAPY ASSOCIATES",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531211722",
"telephone_number": "262-723-3424",
"fax_number": "262-723-8308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAHLER",
"first_name": "VICKI",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "2979",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN CARE",
"identifier": "11532",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkhorn, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.