Wally W Juraschka, PH.D.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMT 104 PE 151 Issued in TN

Practice address

5575 Poplar Ave Ste 320
Memphis, TN 38119-3862

Phone

(901) 763-0909

Fax

(901) 763-4060

NPI assigned

Apr 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1175990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548383367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 FAIRWAY OAKS DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381345587",
            "telephone_number": "901-647-7822",
            "fax_number": "901-763-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 POPLAR AVE STE 320",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193862",
            "telephone_number": "901-763-0909",
            "fax_number": "901-763-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURASCHKA",
        "first_name": "WALLY",
        "middle_name": "W",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "LMT 104 PE 151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Memphis, TN
• Providers in Memphis, TN by specialty
• Marriage & Family Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.