Ethan Teng Xiong, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

123456789 Issued in SC

Practice address

109 Bee St
Charleston, SC 29401-5703

Phone

(843) 789-6500

NPI assigned

Oct 20, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1235911520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 FOLLY ROAD BLVD UNIT 358",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294078314",
            "telephone_number": "651-492-8096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BEE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294015703",
            "telephone_number": "843-789-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIONG",
        "first_name": "ETHAN",
        "middle_name": "TENG",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "123456789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Wyand, MD
• Wendy C Wyatt, RD,LD,CDM
• Rachel Wyllie
• Grace Wyszynski
• Stephanie Brooke Xavier, APRN, DNP, FNP-C
• Grace Xu
• Shan Xue, MD
• Lauren Leslie Yacobucci, MD
• Lindsey Yacullo, FNP-BC
• Mohammad Yaghoobi, MD

• Clinical Psychologist in Charleston, SC
• Providers in Charleston, SC by specialty
• Clinical Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.