Clarie-Ann Henriques Wollach, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS019450 Issued in PA

Practice address

233 E Lancaster Ave Ste 303
Ardmore, PA 19003-2321

Phone

(610) 551-1819

NPI assigned

Mar 11, 2022

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

Other names 1

• Dr. Clarie-Ann Henriques Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1366190100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 W BALTIMORE PIKE # 181",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E LANCASTER AVE STE 303",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032321",
            "telephone_number": "610-551-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLACH",
        "first_name": "CLARIE-ANN",
        "middle_name": "HENRIQUES",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS019450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARIE-ANN",
            "last_name": "HENRIQUES",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Whidbey Island Public Hospital District
• Megan Whitaker, R.D., L.D.N.
• Robert Alan Wilhelm Jr.
• Ruthven A. Wodell, MD
• Charles Joseph Wolf, M.D.
• Michael Wollock
• Alaynia Woodard-Mitchell
• Karen S. Wosiski, APN
• Mark Christopher Yagodich, DPM
• Sultan Hamed M Yahya, MD

• Clinical Psychologist in Ardmore, PA
• Providers in Ardmore, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.