Organization Active NPI

Wavepath Psychological Care, PLLC

  • Clinical Psychologist
  • Wheaton, IL
National Provider Identifier
1205757788
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
WAVEPATH PSYCHOLOGICAL CARE, PLLC
Practice address
2100 Manchester Rd Ste 301
Wheaton, IL 60187-4584
Phone
(787) 447-0533
NPI assigned
Jul 22, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Authorized official

Name
Dr. Marlene Grace Rivera Rodriguez, PSYDNPI 1922852219
Title
Clinical Psychologist
Phone
(787) 447-0533

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

2100 Manchester Rd Ste 301
Wheaton, IL 60187-4584

Mailing address

2100 Manchester Rd Ste 301
Wheaton, IL 60187-4584
Phone (787) 447-0533

National Provider Directory

National Provider Directory

Locations

2100 Manchester Rd
Ste 301
Wheaton, IL 60187
Phone (708) 391-5404

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1784678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1205757788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD STE 301",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874584",
            "telephone_number": "787-447-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD STE 301",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874584",
            "telephone_number": "787-447-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVEPATH PSYCHOLOGICAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-22",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "RIVERA RODRIGUEZ",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "787-447-0533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.