Active NPI
Mary D Wedlock, BA
- Mental Health Counselor
- Wakefield, RI
National Provider Identifier
1447565205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 55 Cherry LN
Wakefield, RI 02879-3617 - Phone
- (401) 789-1367
- Fax
- (401) 364-7705
- NPI assigned
- Aug 17, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
55 Cherry LN
Wakefield, RI 02879-3617
Mailing address
4705A Old Post Rd
Charlestown, RI 02813-1819
Phone (401) 364-7705
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
- Credentials
- Bachelor of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gateway Healthcare Inc | Past | Accepting new patients | |
| South Shore Center Inc | Mental Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Pawtucket, RI
- NPI 1821078932
-
- Group Psychotherapy Psychologist
- Charlestown, RI
- NPI 1255327391
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328140800000",
"number": "1447565205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4705A OLD POST RD",
"city": "CHARLESTOWN",
"state": "RI",
"postal_code": "028131819",
"telephone_number": "401-364-7705",
"fax_number": "401-364-9104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 CHERRY LN",
"city": "WAKEFIELD",
"state": "RI",
"postal_code": "028793617",
"telephone_number": "401-789-1367",
"fax_number": "401-364-7705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEDLOCK",
"first_name": "MARY",
"middle_name": "D",
"credential": "BA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-17",
"last_updated": "2012-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wakefield, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.