Active NPI
Cheryl Wooten, PSY.D.
- Clinical Psychologist
- Waco, TX
National Provider Identifier
1376978379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 36380
- Practice address
- 1 Bear PL Unit 97060
Waco, TX 76798-7060 - Phone
- (254) 710-2467
- NPI assigned
- Sep 9, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 36380 | TX | Primary |
Addresses
Primary practice location
1 Bear PL Unit 97060
Waco, TX 76798-7060
Mailing address
1 Bear PL Unit 97060
Waco, TX 76798-7060
Phone (254) 710-2467
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36380 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437091200000",
"number": "1376978379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BEAR PL UNIT 97060",
"city": "WACO",
"state": "TX",
"postal_code": "767987060",
"telephone_number": "254-710-2467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BEAR PL UNIT 97060",
"city": "WACO",
"state": "TX",
"postal_code": "767987060",
"telephone_number": "254-710-2467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOTEN",
"first_name": "CHERYL",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-09",
"last_updated": "2015-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "36380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.