Sandra M Wick, PH.D., L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP2578 Issued in MN

Practice address

2399 Ariel St N Ste D
Maplewood, MN 55109-2202

Phone

(651) 770-1311

Fax

(651) 770-1879

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1285784405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2399 ARIEL ST N STE D",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092203",
            "telephone_number": "651-770-1311",
            "fax_number": "651-770-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2399 ARIEL ST N STE D",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092202",
            "telephone_number": "651-770-1311",
            "fax_number": "651-770-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICK",
        "first_name": "SANDRA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP2578",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "LMFT0280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Wetterling, MA OTR/L
• Kara Wheeler, RD, LD
• Jessica K Whelan, MD
• Margaret Whipple
• Jennifer Joy Whitcomb, OTRL
• Ingrid Elizabeth Wilbrand-Conley, MD
• Amila Dilusha William, MD
• Alyssa Rae Williams, LPN
• Laura Lee Williams, MA OTRL
• Meghan Williams, PHD, LMFT

• Clinical Psychologist in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.