Active NPI
Colleen Barbara Wentworth, PSYD
- Clinical Psychologist
- Cary, NC
National Provider Identifier
1568675320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5746
- Practice address
- 1350 SE Maynard Rd Ste 101
Cary, NC 27511-3634 - Phone
- (603) 933-0934
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 5746 | NC | Primary |
Addresses
Primary practice location
1350 SE Maynard Rd Ste 101
Cary, NC 27511-3634
Mailing address
101 Keystone Dr
Cary, NC 27513-2809
Phone (603) 933-0934
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30424790 | Medicaid | NH |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758067200000",
"number": "1568675320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 KEYSTONE DR",
"city": "CARY",
"state": "NC",
"postal_code": "275132809",
"telephone_number": "603-933-0934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 SE MAYNARD RD STE 101",
"city": "CARY",
"state": "NC",
"postal_code": "275113634",
"telephone_number": "603-933-0934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENTWORTH",
"first_name": "COLLEEN",
"middle_name": "BARBARA",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2025-09-17",
"certification_date": "2025-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "5746",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30424790",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.