Organization Active NPI

Allyson Ende, PSYD LLC

  • Psychologist
  • Wausau, WI
National Provider Identifier
1447824875
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
ALLYSON ENDE, PSYD LLC
Practice address
227500 Rib Mountain Dr Ste 103
Wausau, WI 54401-5052
Phone
(715) 348-2828
NPI assigned
May 19, 2021
Last updated
May 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Authorized official

Name
Allyson Ende, PSY.D.NPI 1487866455
Title
Owner
Phone
(715) 348-2828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

227500 Rib Mountain Dr Ste 103
Wausau, WI 54401-5052

Mailing address

1720 Highwood LN
Wausau, WI 54403-8131
Phone (715) 348-2828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210706002640 WI Part B Supplier - Clinic/Group Practice 1254733835 Receives reassigned benefits from 1 practitioner
Practice locations: Wausau, WI

National Provider Directory

National Provider Directory

Locations

227500 Rib Mountain Dr
Ste 103
Rib Mountain, WI 54401
Phone (715) 348-2828

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1447824875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 HIGHWOOD LN",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544038131",
            "telephone_number": "715-348-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227500 RIB MOUNTAIN DR STE 103",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015052",
            "telephone_number": "715-348-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLYSON ENDE, PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "ENDE",
        "authorized_official_first_name": "ALLYSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-348-2828",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.