Individual provider Active NPI

Christina Siders Wesley

  • Psychologist
  • Northville, MI
National Provider Identifier
1346755345
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301017325 Issued in MI
Practice address
315 N Center St
Northville, MI 48167-1277
Phone
(313) 656-4052
NPI assigned
Dec 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 6301017325 MI Primary

Addresses

Primary practice location

315 N Center St
Northville, MI 48167-1277

Mailing address

7448 N Lafayette St
Dearborn Heights, MI 48127-1759
Phone (248) 890-1025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6301017325MIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1346755345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7448 N LAFAYETTE ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271759",
            "telephone_number": "248-890-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N CENTER ST",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671277",
            "telephone_number": "313-656-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESLEY",
        "first_name": "CHRISTINA",
        "middle_name": "SIDERS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301017325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.