Justina Pittman Wagers, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2000 Issued in CO

Practice address

1777 Exposition Dr
Boulder, CO 80301-2628

Phone

(303) 442-2532

NPI assigned

Dec 20, 2013

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)

Not enrolled

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.

• University of Colorado, Boulder'S Women'S Mental Health & Wellness Cli

  • Health Maintenance Organization
  • Boulder, CO
  • NPI 1568731941
  NPD (past)

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1376964114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAMPUS BOX 345",
            "address_2": "CU-BOULDER DEPT OF PSYCHOLOGY AND NEUROSCIENCE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803090345",
            "telephone_number": "303-442-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 EXPOSITION DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012628",
            "telephone_number": "303-442-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGERS",
        "first_name": "JUSTINA",
        "middle_name": "PITTMAN",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-20",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Gerilyn Wade-Stein, PH.D.
• Darcy Wade, MA, LPCC
• Patricia M Wade, CCC-SLP
• Dawn Carlisle Wadsworth, MS, BCBA,
• Cherlyn Wager, B.A.
• Dylan Kurt Wagner, PT, DPT
• John M. Wagner, M.S.
• Jonathan Stuart Wagner, LPCC
• Kristin M Wagner, M.A., L.P.C., N.C.C.
• Matthew Wagner, P.T.

• Clinical Psychologist in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.