Theodore Wasserman, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY3977 Issued in FL

Practice address

5325 Greenwood Ave
Suite 201
West Palm Beach, FL 33407-2452

Phone

(561) 881-2822

Fax

(561) 881-0972

NPI assigned

Jan 31, 2007

Sex

Male

Sole proprietor

No

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437296159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 GREENWOOD AVE",
            "address_2": "SUITE 201",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072452",
            "telephone_number": "561-881-2822",
            "fax_number": "561-881-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 GREENWOOD AVE",
            "address_2": "SUITE 201",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072452",
            "telephone_number": "561-881-2822",
            "fax_number": "561-881-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "THEODORE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY3977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven L Warshall, M.D.
• Lee Washington-Mawali, M.A.
• Jasmine Washington
• Kamera Washington, MS SLP
• Angela Wasielewski, CRNA
• Lorna Alexis Waters
• Waterway Scientific, LLC
• Donald R Watren, MD
• Crystal A Watson
• Kimesha Watson

• Clinical Child & Adolescent Psychologist in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Clinical Child & Adolescent Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.