Heather Wong Bailey, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

8260 Issued in MA

Practice address

1 Mifflin PL
Suite 260
Cambridge, MA 02138-4907

Phone

(617) 513-1004

NPI assigned

Jan 29, 2007

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

Other identifiers 3

Other names 1

• Heather Wong Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1205972106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 MASSACHUSETTS AVE",
            "address_2": "APARTMENT 316",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393327",
            "telephone_number": "617-513-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MIFFLIN PL",
            "address_2": "SUITE 260",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384907",
            "telephone_number": "617-513-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG BAILEY",
        "first_name": "HEATHER",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "8260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110076761",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MA",
            "identifier": "W 06347",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9967078",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "WONG",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emma Wolfman
• Mary M Wolfman, M.D.
• Edward Wolpow, MD
• Suzan E Wolpow, M.S., LMHC, LRC, CRC
• Women'S Mental Health Collective, Inc.
• Deborah Wong, MD
• Joseph S Wong, MD
• Lani Rose Wong, LICAC, MAC
• Lawrence Wong
• Winnie Wong

• Psychologist in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.