Wandamaria B Lopez, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY001532 Issued in GA

Practice address

2935 N Ashley St
Suite F
Valdosta, GA 31602-1777

Phone

(229) 333-2273

Fax

(229) 293-7911

NPI assigned

Jul 10, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

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, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Better Mood Clinic S Ga LLCGroup PAC ID 0941472617, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/bettermoodclinic/r4/

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.

• Better Mood Clinic S Ga LLC

  • Clinical Social Worker
  • Valdosta, GA
  • NPI 1154603470
  Medicare reassignment Care Compare group NPD
• One-to-One Psychological Services

  • Clinical Psychologist
  • Nashville, GA
  • NPI 1437282431
  NPD (past) Authorized official
• Better Mood Clinic

  • Clinical Social Worker
  • Valdosta, GA
  • NPI 1326289059
  NPD (past)
• Peaceway Counseling & Mediation Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valdosta, GA
  • NPI 1215113675
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1124052667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2935 N ASHLEY ST",
            "address_2": "SUITE F",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021777",
            "telephone_number": "229-333-2273",
            "fax_number": "229-293-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 N ASHLEY ST",
            "address_2": "SUITE F",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021777",
            "telephone_number": "229-333-2273",
            "fax_number": "229-293-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "WANDAMARIA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY001532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "XXXXX9255",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "281450LO",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000463724B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Livingstone a. Rasalam, M.D. P.C.
• David Martin Loggans II, LPC
• Taylor Pegg Logue, DNP, FNP-C
• Aamira Lomax
• Cristina Marie Lopez, MD
• Rosalba Lorenzo, OTR/L
• Lori Stubbs LLC
• Linda Lorincz, RBT
• Thomas M Lott Jr., M.D.
• Halleigh Lane Lovein, NP

• Clinical Psychologist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.