Christina Lynne Wise, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

36522 Issued in TX

Practice address

10427 Cromwell Dr
Dallas, TX 75229-5949

Phone

(617) 669-0435

NPI assigned

May 5, 2016

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

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 and National Provider Directory roles.

• Dallas County Mental Health & Mental Retardation Center

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1023239886
  NPD

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1104272491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10427 CROMWELL DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752295949",
            "telephone_number": "617-669-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10427 CROMWELL DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752295949",
            "telephone_number": "617-669-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "CHRISTINA",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-05",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "36522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anbereen Wiqar, OTR
• Wisconsin Outpatient Services SC
• Wise Nutrition Counseling LLC
• Amanda Tuyet-Anh Wise, D.O.
• Anna Wise, MS, CCC-SLP
• Kenneth F. Wise, PSY.D.
• Margaret F Wise, OTR, CHT, CVE
• Matthew W. Wise, DO
• Ciara Lauren Wisecup, MD
• Maren E Wiseheart, ARNP

• Counseling Psychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.