Jolynn Wagner, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00002370 Issued in WA

Practice address

26502 NE Valley St Suite 101
Duvall, WA 98019

Phone

(425) 343-3289

NPI assigned

May 31, 2007

Last updated

Mar 21, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 DE

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Psychological Services P.a.

  dba Newark Behavioral Health

  • Psychologist
  • Newark, DE
  • NPI 1932754595
  Medicare reassignment NPD
• Redwood Psychological & Counseling Services PLLC

  • Clinical Psychologist
  • Duvall, WA
  • NPI 1710654918
  NPD

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1093917320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26502 NE VALLEY ST SUITE 101",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "98019",
            "telephone_number": "425-343-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26502 NE VALLEY ST SUITE 101",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "98019",
            "telephone_number": "425-343-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JOLYNN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Unified Counseling, PLLC
• Christine Valluzzi
• Maura (Mary) Angela Van Ness, L.M.P.
• Kari Lynn Vanderhouwen, RPH
• Christian Tyler Vasileff, CBT
• Tina Marie Ward, ARNP
• Jessica Ann Weiss, LMP
• Whole Valley Therapy, PLLC (Whole Valley Therapy)
• Meghan Margaret Wilkins Melanson, LMHCA
• Danielle Winterwood, MSW, LICSW

• Clinical Psychologist in Duvall, WA
• Providers in Duvall, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.