Active NPI
Carly D Wise, M.S., ED. S.
- School Psychologist
- Claysville, PA
National Provider Identifier
1194177428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 2539197
- Practice address
- 119 Main St
Claysville, PA 15323-2396 - Phone
- (724) 665-5364
- Fax
- (724) 663-3696
- NPI assigned
- Jul 11, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 2539197 | PA | Primary |
Addresses
Primary practice location
119 Main St
Claysville, PA 15323-2396
Mailing address
119 Main Street
PO Box 421
Claysville, PA 15301
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2539197 | PA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468195200000",
"number": "1194177428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 MAIN STREET",
"address_2": "PO BOX 421",
"city": "CLAYSVILLE",
"state": "PA",
"postal_code": "15301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 MAIN ST",
"city": "CLAYSVILLE",
"state": "PA",
"postal_code": "153232396",
"telephone_number": "724-665-5364",
"fax_number": "724-663-3696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE",
"first_name": "CARLY",
"middle_name": "D",
"credential": "M.S., ED. S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-11",
"last_updated": "2016-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "PA",
"license": "2539197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Claysville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.