Dr. Mary Wanat PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P2041 Issued in TN

Legal business name

DR. MARY WANAT PLLC

Practice address

8820 Trinity Rd Ste 200
Cordova, TN 38018-2735

Phone

(901) 385-2342

Fax

(901) 382-0140

NPI assigned

Jun 11, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mary Wanat, PHD

Title

Owner

Phone

(901) 756-8398

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1447698568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8820 TRINITY RD STE 200",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380182735",
            "telephone_number": "901-385-2342",
            "fax_number": "901-382-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 TRINITY RD STE 200",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380182735",
            "telephone_number": "901-385-2342",
            "fax_number": "901-382-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARY WANAT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "WANAT",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-756-8398",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P2041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3064204",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Cordova, TN
• Providers in Cordova, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.