Thomas Joseph Waltz, PH.D., L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301016487 Issued in MI

Practice address

715 Cambridge St
Ypsilanti, MI 48197-2127

Phone

(734) 340-4043

NPI assigned

May 7, 2010

Last updated

May 15, 2021By the provider in NPPES

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

Other identifiers 1

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": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621036800000",
    "number": "1275851875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 CAMBRIDGE ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481972127",
            "telephone_number": "734-340-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 CAMBRIDGE ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481972127",
            "telephone_number": "734-340-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTZ",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-07",
        "last_updated": "2021-05-15",
        "certification_date": "2021-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN PSYCHOLOGY BOARD",
            "identifier": "6301016487",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annie Sue Walls
• John W Walsh, M.D.
• Martha M Walsh, M.D.
• Ioana Chrisan Walter, RN
• Amy Waltz
• Justin Richard Walukonis, CRNA
• Matthew Warblow, LMSW
• Earquella Ward, LMT, BCTMB
• Jarrett Troy Ward
• Richard Ward

• Clinical Psychologist in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2021; 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.