Jamal Waire, PSYD

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

Practice address

4845 Pearl East Cir Ste 118
Boulder, CO 80301-6112

Phone

(720) 464-7515

NPI assigned

Oct 19, 2022

Last updated

Jul 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Practice roles

Locations

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.

• Grounded Mind Psychology PLLC

  • Psychologist
  • Broomfield, CO
  • NPI 1073478137
  NPD Authorized official

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1295451417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 PEARL EAST CIR STE 118",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803016112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 PEARL EAST CIR STE 118",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803016112",
            "telephone_number": "720-464-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIRE",
        "first_name": "JAMAL",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-19",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Lynn Wagner
• John M. Wagner, M.S.
• Jonathan Stuart Wagner, LPCC
• Kristin M Wagner, M.A., L.P.C., N.C.C.
• Matthew Wagner, P.T.
• Kaylin Wakuzawa
• Audrey M Waldron, P.T.
• Waldron's Peak Physical Therapy, P.C.
• Abigail Esther Wales
• Walgreen Co (Walgreens #02482)

• Cognitive & Behavioral Psychologist in Boulder, CO
• Providers in Boulder, CO by specialty
• Cognitive & Behavioral Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.