Daniel L Wise, PH.D., PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

DANIEL L WISE, PH.D., PA

Practice address

5200 Willson Rd Ste 205
Edina, MN 55424-1343

Phone

(612) 875-4449

NPI assigned

Jun 15, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Wise, PH.D.NPI 1245465558

Title

President/Licensed Psychologist

Phone

(612) 875-4449

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Lynn Wise, PHD, LP

  • Clinical Psychologist
  • Edina, MN
  • NPI 1245465558
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1528636511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 WILLSON RD STE 205",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554241343",
            "telephone_number": "612-875-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 WILLSON RD STE 205",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241343",
            "telephone_number": "612-875-4449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32 18th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554184202",
            "country_code": "US",
            "telephone_number": "612-875-4449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DANIEL L WISE, PH.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT/LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "612-875-4449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy S Daleiden, MD
• Jessee Ann Daley, MA, LPCC
• Kelli F Daly, ANP
• Dan-MN, Inc
• Vinh Dang, MPAS, PA-C
• Daniel Legerski, Psy.D., LP, LLC
• Jessica Lynn Daniels, M.A. SLP
• Mari Daniels, M.D.
• Shannon L Daniels, MD
• Constance Jennifer Dankle, D.O.

• Clinical Psychologist in Edina, MN
• Providers in Edina, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.