Sue Anne Wiedenfeld, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

1354 Issued in WA

Practice address

2808 E Madison St
Suite 201
Seattle, WA 98112-4862

Phone

(206) 323-6909

Fax

(206) 324-0867

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brian D Jaeger MD PS Inc

  • Adult Mental Health Clinic/Center
  • Redmond, WA
  • NPI 1396915385
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295941193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 E MADISON ST",
            "address_2": "SUITE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124862",
            "telephone_number": "206-323-6909",
            "fax_number": "206-324-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 E MADISON ST",
            "address_2": "SUITE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124862",
            "telephone_number": "206-323-6909",
            "fax_number": "206-324-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDENFELD",
        "first_name": "SUE",
        "middle_name": "ANNE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "1354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail K Wiebusch, MD
• Carla M Wiechman, LMP
• Shelley Ann Wiechman, PHD
• Matthew Wieck
• Benjamin J Wieczorek, LMP
• Gary B Wieder, PH.D.
• John Wiederspan
• Christopher Houston Wiedle Jr.
• Austin Wiedmaier
• Geoffrey A Wiegand, PH.D., PLLC

• Counseling Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Counseling Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.