Jesse Alexander Wingate, M.S.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810007314 Issued in VA

Practice address

17068 Lankford Highway
Eastville, VA 23347-2334

Phone

(757) 331-1086

NPI assigned

Jul 11, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Wingate Psychological Services, LLC

  • Adult Mental Health Clinic/Center
  • Exmore, VA
  • NPI 1861265274
  NPD Authorized official

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1184276974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17068 LANKFORD HIGHWAY",
            "city": "EASTVILLE",
            "state": "VA",
            "postal_code": "23347",
            "telephone_number": "573-311-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17068 LANKFORD HIGHWAY",
            "city": "EASTVILLE",
            "state": "VA",
            "postal_code": "233472334",
            "telephone_number": "757-331-1086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7714 Conner Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Powell",
            "state": "TN",
            "postal_code": "378493559",
            "country_code": "US",
            "telephone_number": "865-947-6220",
            "fax_number": "865-512-1069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "815 W 5th North St",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "TN",
            "postal_code": "378143810",
            "country_code": "US",
            "telephone_number": "423-586-5032",
            "fax_number": "423-581-8473",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14558 Danville Pike",
            "address_purpose": "LOCATION",
            "city": "Laurel Fork",
            "state": "VA",
            "postal_code": "243523982",
            "country_code": "US",
            "telephone_number": "276-398-2292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINGATE",
        "first_name": "JESSE",
        "middle_name": "ALEXANDER",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralph M Sanchez, M.D.
• Grace St. Pierre, FNP-C
• Paul Morgan Stevenson, PA-C
• Uday Tiwari, MBBS
• Kelly M Washburn, M.D.
• Nicole Freda Wynder, NCC,LPC, LMFT, LCMHC
• Jonathan S. Yankes, PA-C

• Clinical Psychologist in Eastville, VA
• Providers in Eastville, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.