Active NPI
Jason Wang, PH.D.
- Counseling Psychologist
- Coralville, IA
National Provider Identifier
1417873704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Practice address
- 2240 9TH St
Coralville, IA 52241-1575 - Phone
- (319) 800-5564
- NPI assigned
- Jun 29, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | Primary |
Addresses
Primary practice location
2240 9TH St
Coralville, IA 52241-1575
Mailing address
2240 9TH St
Coralville, IA 52241-1575
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Counseling Services PLLC | Counseling | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782691200000",
"number": "1417873704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2240 9TH ST",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522411575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2240 9TH ST",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522411575",
"telephone_number": "319-800-5564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "JASON",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-06-29",
"last_updated": "2026-06-29",
"certification_date": "2026-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Coralville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.