Hallie Denise Landreth, PH D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20041743A Issued in IN

Practice address

6900 Alden Dr
90 MDG
Fe Warren Afb, WY 82005-3906

Phone

(307) 773-2998

Fax

(307) 773-4721

NPI assigned

Sep 20, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Hallie Denise Wilborne Former name

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1316932916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 ALDEN DR",
            "address_2": "90 MDG",
            "city": "FE WARREN AFB",
            "state": "WY",
            "postal_code": "820053906",
            "telephone_number": "307-773-2998",
            "fax_number": "307-773-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 ALDEN DR",
            "address_2": "90 MDG",
            "city": "FE WARREN AFB",
            "state": "WY",
            "postal_code": "820053906",
            "telephone_number": "307-773-2998",
            "fax_number": "307-773-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRETH",
        "first_name": "HALLIE",
        "middle_name": "DENISE",
        "credential": "PH D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041743A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALLIE",
            "last_name": "WILBORNE",
            "middle_name": "DENISE",
            "credential": "PH D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonah Phillip Justice
• Jodi Lynn Keithley, RD, LD
• Brooke R Kibel, OD, FAAO
• Vance Knauer, DMD
• Mallory Ann Krueger, DO
• Haley Isham Lawson, PA-C
• Lisa Sung Eun Lee, PHARM D
• Shannon Freshwater Long, PA-C
• Brian Gregory Lusk, DDS
• Jeanette Joan Lynch, LCSW

• Clinical Psychologist in Fe Warren Afb, WY
• Providers in Fe Warren Afb, WY by specialty
• Clinical Psychologist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.