Individual provider Active NPI

Ashley Widner, MA, TMLP

  • Psychologist
  • Wyoming, MI
National Provider Identifier
1265271944
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6362009922 Issued in MI
Practice address
1009 44TH St SW Ste 103
Wyoming, MI 49509-4480
Phone
(269) 459-1818
Fax
(269) 365-9951
NPI assigned
May 22, 2024
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6362009922 MI Primary

Addresses

Primary practice location

1009 44TH St SW Ste 103
Wyoming, MI 49509-4480

Mailing address

5708 Venture CT Ste B
Kalamazoo, MI 49009-2858
Phone (269) 459-1818

Other practice location 1

300 68th St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

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 Arts

State licenses

LicenseStateTypeSpecialty
6362009922MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Meredith Psychological and Testing Services, LLC CurrentSince May 26, 2024 Accepting new patients

Locations

5708 Venture Ct
Ste B
Kalamazoo, MI 49009
Phone (269) 459-1818

1009 44th St SW
Ste 103
Wyoming, MI 49509
Phone (269) 459-1818

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1265271944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5708 VENTURE CT STE B",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092858",
            "telephone_number": "269-459-1818",
            "fax_number": "269-365-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 44TH ST SW STE 103",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495094480",
            "telephone_number": "269-459-1818",
            "fax_number": "269-365-9951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 68th St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495486927",
            "country_code": "US",
            "telephone_number": "616-455-5000",
            "fax_number": "616-281-6459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIDNER",
        "first_name": "ASHLEY",
        "credential": "MA, TMLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6362009922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.