Janice Wachtel, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY0005827 Issued in FL

Practice address

100 Executive Way
Ste 110
Ponte Vedra Beach, FL 32082-4753

Phone

(904) 834-2235

Fax

(866) 531-8858

NPI assigned

Aug 21, 2006

Last updated

Feb 3, 2022By 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 FL

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Janice Wachtel, PHD, LLC

  • Clinical Psychologist
  • Ponte Vedra Beach, FL
  • NPI 1811308901
  Medicare reassignment NPD Authorized official
• Marsh Landing Behavioral Group Inc

  • Child & Adolescent Psychiatry Physician
  • Jacksonville Beach, FL
  • NPI 1124143490
  NPD (past)
• Stuart Young, PH.D. Associates P.a.

  • Psychologist
  • Neptune Beach, FL
  • NPI 1548469711
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1134235641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EXECUTIVE WAY",
            "address_2": "STE 110",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824753",
            "telephone_number": "904-834-2235",
            "fax_number": "866-531-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EXECUTIVE WAY",
            "address_2": "STE 110",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824753",
            "telephone_number": "904-834-2235",
            "fax_number": "866-531-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACHTEL",
        "first_name": "JANICE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0005827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darian Vines, PHYSICIAN ASSISTANT
• Vision Express
• Paul L Vitulli, DO
• Kyle Brendan Volland, PHARM.D.
• Stephanie Anne Voshell, HAS
• Bambi Lynn Wadelton, PLHD
• Susan Smicklas Wadsworth, OT
• Walgreen Co (Walgreens #04657)
• Claudette Narcisa Walker, ARNP
• Georganna Walker, OT

• Clinical Psychologist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.