Active NPI
Henry Arness Wynne Jr., PH.D.
- Clinical Psychologist
- Atlanta, GA
National Provider Identifier
1568937530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY.1519PSY
- Practice address
- 1701 Hardee Ave SW
Atlanta, GA 30310-5110 - Phone
- (404) 321-6111
- NPI assigned
- Oct 5, 2018
- Sex
- Male
- 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 | PSY.1519PSY | SC | Primary |
Addresses
Primary practice location
1701 Hardee Ave SW
Atlanta, GA 30310-5110
Mailing address
213 Tamarron Pkwy SE
Atlanta, GA 30339-0202
Phone (314) 489-2228
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 |
|---|---|---|---|
| PSY.1519PSY | SC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538697600000",
"number": "1568937530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 TAMARRON PKWY SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303390202",
"telephone_number": "314-489-2228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 HARDEE AVE SW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303105110",
"telephone_number": "404-321-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYNNE",
"first_name": "HENRY",
"middle_name": "ARNESS",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-05",
"last_updated": "2018-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "PSY.1519PSY",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.