Jill Levey Waxman, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY002824 Issued in GA

Practice address

105 Arnold Mill Rd
Woodstock, GA 30188-5027

Phone

(770) 926-0016

Fax

(770) 926-0969

NPI assigned

May 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Develabilities, LLC

  • Clinical Psychologist
  • Woodstock, GA
  • NPI 1114083839
  NPD Authorized official
• Develabilities

  • Clinical Psychologist
  • Roswell, GA
  • NPI 1962176933
  Authorized official Same address or phone
• Ameripartner Inc.

  • Clinical Psychologist
  • Dalton, GA
  • NPI 1023067626
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578513404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 HEATH LN",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625901",
            "telephone_number": "770-833-0885",
            "fax_number": "770-565-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ARNOLD MILL RD",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301885027",
            "telephone_number": "770-926-0016",
            "fax_number": "770-926-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXMAN",
        "first_name": "JILL",
        "middle_name": "LEVEY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "893674432A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Faye Waters, LPC
• Harry Daniel Watkins Jr., M.D.
• Gwyn Morgan Watson
• Katie Jeanes Watson
• Jason Edward Watts, PMHNP
• Weatherstone Medical Care LLC.
• Ashley Wedgworth, D.C.
• Michele Cloy Weeks, PT
• Samuel Wehby Jr., PT
• Steven A Weiskopf, D.P.M.

• Clinical Psychologist in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Clinical Psychologist in Georgia

• 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.