Lisa Lauren Wajsblat, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

189 Wheatley Rd
Glen Head, NY 11545-2641

Phone

(516) 686-4440

Fax

(516) 686-4439

NPI assigned

Aug 11, 2012

Last updated

Aug 11, 2012By the provider in NPPES

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

Opted out of Medicare

Yes, effective Jun 26, 2024 through Jun 26, 2028

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1344643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344643200000",
    "number": "1447507298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VINCENT RD",
            "address_2": "APT 2O",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107086518",
            "telephone_number": "917-613-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 WHEATLEY RD",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115452641",
            "telephone_number": "516-686-4440",
            "fax_number": "516-686-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAJSBLAT",
        "first_name": "LISA",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-11",
        "last_updated": "2012-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisa Ventur, PH.D.
• Delia P Verna, LMFT
• Victor Marchese, LCSW, PC
• Victoria Capobianco D.O. PLLC
• Breanna Vizlakh, PHD
• Janet Marie Wallick, MA,CCC-SLP
• Kimberly Marie Warga, M.S ED
• Ana Wegmann
• Nicole Francesca Weiden
• Darci Susan Weissbrot, RD

• Psychologist in Glen Head, NY
• Providers in Glen Head, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.