Active NPI
Jean-Claude I Wakim, PH.D.
- Family Psychologist
- Dallas, TX
National Provider Identifier
1114923562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Psychologist
- License
- 25106
- Practice address
- 16200 N. Dallas Pkwy
Ste 280
Dallas, TX 75248-2684 - Phone
- (972) 768-2290
- Fax
- (972) 335-7642
- NPI assigned
- Jun 21, 2005
- Reactivated
- Mar 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Development & Aging Psychologist | 103TA0700X | 25106 | TX | |
| Clinical Psychologist | 103TC0700X | 25106 | TX | |
| Family Psychologist | 103TF0000X | 25106 | TX | Primary |
Addresses
Primary practice location
16200 N. Dallas Pkwy
Ste 280
Dallas, TX 75248-2684
Mailing address
16200 N. Dallas Pkwy
Ste 280
Dallas, TN 75248-2684
Phone (972) 768-2290
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080627000255 | TX | Practitioner - Clinical Psychologist | 4284706789 | Practice locations: Plano, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25106 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1114923562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16200 N. DALLAS PKWY",
"address_2": "STE 280",
"city": "DALLAS",
"state": "TN",
"postal_code": "752482684",
"telephone_number": "972-768-2290",
"fax_number": "972-335-7642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16200 N. DALLAS PKWY",
"address_2": "STE 280",
"city": "DALLAS",
"state": "TX",
"postal_code": "752482684",
"telephone_number": "972-768-2290",
"fax_number": "972-335-7642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKIM",
"first_name": "JEAN-CLAUDE",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-21",
"last_updated": "2025-09-11",
"deactivation_date": "2006-03-21",
"reactivation_date": "2006-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "TX",
"license": "25106",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "25106",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "TX",
"license": "25106",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
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- Naureen Wajahat
- Stephanie Necole Wakefield, DDS
- Nausheen Wakhlu, MD
- Sidarth Wakhlu, M.D.
- Yosafe Wakwaya, M.D.
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.