Patricia J Walz, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

90-18P Issued in AR

Practice address

1401 S Waldron Rd Ste 206
Fort Smith, AR 72903-2590

Phone

(479) 785-1995

Fax

(479) 308-3971

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1457452161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S WALDRON RD STE 206",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032590",
            "telephone_number": "479-785-1995",
            "fax_number": "479-308-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S WALDRON RD STE 206",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032590",
            "telephone_number": "479-785-1995",
            "fax_number": "479-308-3971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 S Waldron Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729032552",
            "country_code": "US",
            "telephone_number": "479-785-1995",
            "fax_number": "479-785-4248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALZ",
        "first_name": "PATRICIA",
        "middle_name": "J",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "90-18P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118624719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Logan Wampler, QBHP
• Lisa Wangler, RN
• Brett Ward
• Chesney Ward, MHPP
• Connie Jin Ward, APN

• Psychologist in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; 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.