Active NPI
Michelle Marie Wankmuller, PH.D.
- Clinical Psychologist
- Fort Lee, NJ
National Provider Identifier
1467917633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35SI00598800
- Practice address
- 1605 John St Ste 205B
Fort Lee, NJ 07024-2581 - Phone
- (917) 589-4939
- NPI assigned
- Feb 1, 2019
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00598800 | NJ | Primary |
Addresses
Primary practice location
1605 John St Ste 205B
Fort Lee, NJ 07024-2581
Mailing address
1260 Sleepy Hollow LN
Scotch Plains, NJ 07076-2230
Phone (917) 589-4939
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00598800 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548979200000",
"number": "1467917633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1260 SLEEPY HOLLOW LN",
"city": "SCOTCH PLAINS",
"state": "NJ",
"postal_code": "070762230",
"telephone_number": "917-589-4939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 JOHN ST STE 205B",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070242581",
"telephone_number": "917-589-4939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANKMULLER",
"first_name": "MICHELLE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-01",
"last_updated": "2019-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00598800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.