Marilyn M. Wagner PH.D., PSC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

0553 Issued in KY

Legal business name

MARILYN M. WAGNER PH.D., PSC

Practice address

105A Crescent Ave
Louisville, KY 40206-1525

Phone

(502) 893-4011

NPI assigned

Aug 20, 2008

Last updated

Aug 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marilyn M Wagner, PHD

Title

President

Phone

(502) 893-4011

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeanne Marie Bennett, PSY.D.

  • Clinical Neuropsychologist
  • Louisville, KY
  • NPI 1164429320
  NPD (past)
• Margaret Elizabeth Smedley, PH.D.

  • Psychologist
  • Louisville, KY
  • NPI 1851589691
  NPD (past)

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1265689475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105A CRESCENT AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061525",
            "telephone_number": "502-893-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105A CRESCENT AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061525",
            "telephone_number": "502-893-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILYN M. WAGNER PH.D., PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-20",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-893-4011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "0553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Renee Maupin (Splendid Scarab)
• Marian Home-Ursuline Sisters
• Marianne Cowley, M.D.,PLC
• Mariano a Galang III M.D., PSC
• Marigold Counseling
• Marius Marin
• Marina Sud
• Bradley Dale Marine, LPCC
• Andriana Marino, LPN
• Amanda Maris, MS, OTR/L

• Clinical Neuropsychologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Neuropsychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.