Individual provider Active NPI

Mei-Chuan Wang, PH.D

  • Psychologist
  • Fayetteville, NC
National Provider Identifier
1184943003
Registry record updated Feb 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4352 Issued in NC
Practice address
596 Executive PL Ste 102
Fayetteville, NC 28305-5189
Phone
(910) 758-1799
Fax
(910) 781-8700
NPI assigned
May 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Psychologist 103T00000X 4352 NC Primary

Addresses

Primary practice location

596 Executive PL Ste 102
Fayetteville, NC 28305-5189

Mailing address

596 Executive PL Ste 102
Fayetteville, NC 28305-5189
Phone (910) 758-1799

Other identifiers 2

IdentifierTypeStateIssuer
6104526MedicaidNC
472557OtherMHN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20140401001459 NC Practitioner - Clinical Psychologist 4284865445 Reassigns benefits to 1 organization
Practice locations: Fayetteville, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wang Psychological Services PLLCGroup PAC ID 2668806605, 2 clinicians

Practice addresses (Care Compare)

596 Executive PL
Suite 102
Fayetteville, NC 28305-5189
Phone (910) 758-1799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4335NCMDChiropractor
4352NCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wang Psychological Services PLLC Mental Health CurrentSince Oct 9, 2019 Accepting new patients

Locations

596 Executive Pl
Ste 102
Fayetteville, NC 28305
Phone (910) 758-1799

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644710400000",
    "number": "1184943003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 EXECUTIVE PL STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055189",
            "telephone_number": "910-758-1799",
            "fax_number": "910-781-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 EXECUTIVE PL STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055189",
            "telephone_number": "910-758-1799",
            "fax_number": "910-781-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "MEI-CHUAN",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-18",
        "last_updated": "2022-02-13",
        "certification_date": "2022-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "4352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104526",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "472557",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.