Marvin Wasman, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1002 Issued in OH

Practice address

23230 Chagrin Blvd
Suite 350
Beachwood, OH 44122-5446

Phone

(216) 831-2900

Fax

(216) 831-4306

NPI assigned

Sep 27, 2006

Sex

Male

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

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578654596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23230 CHAGRIN BLVD",
            "address_2": "SUITE 350",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225446",
            "telephone_number": "216-831-2900",
            "fax_number": "216-831-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23230 CHAGRIN BLVD",
            "address_2": "SUITE 350",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225446",
            "telephone_number": "216-831-2900",
            "fax_number": "216-831-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASMAN",
        "first_name": "MARVIN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "1002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC & BS",
            "identifier": "000000197157",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Louise Waseleski, LPCC
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• Ashley Nicole Wasosky
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• Angela M Watkins
• Ashley Watkins
• Valisha Watkins

• Clinical Psychologist in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Clinical Psychologist in Ohio

• 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.