John Paul Wunderlich, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2020009163 Issued in MO

Practice address

1129 Macklind Ave
Saint Louis, MO 63110-1440

Phone

(314) 881-3487

Fax

(314) 534-7996

NPI assigned

Jul 6, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Four County Comprehensive Mental Health Center, Inc

  dba 4C Health

  • Psychiatric Hospital
  • Peru, IN
  • NPI 1457539751
  NPD (past)

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1568958239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 MACKLIND AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101440",
            "telephone_number": "314-881-3487",
            "fax_number": "314-534-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 MACKLIND AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101440",
            "telephone_number": "314-881-3487",
            "fax_number": "314-534-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLICH",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-06",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2020009163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Ann Wuellner, AGACNP
• Josh Wuerffel, RBT
• Ella Marie Wulf
• Michael Wulfekuhle, D.C.
• Joseph G Wulgaert, LMSW
• Lisa Leanne Wunsch, LPC
• Roy Wunsch
• Laci J Wurm, DPT, ATC
• Jamie Wurth, F.N.P.
• Hayley M Wurzel, MD

• Clinical Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.