Western Ohio Psychological Services LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7027 Issued in OH

Legal business name

WESTERN OHIO PSYCHOLOGICAL SERVICES LLC

Practice address

110 E Poplar St
Ste. 7
Sidney, OH 45365-2985

Phone

(937) 638-5210

NPI assigned

Jun 13, 2016

Last updated

Aug 17, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacqueline Allen

Title

PSYD

Phone

(973) 638-5210

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1578913356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E POPLAR ST",
            "address_2": "STE. 7",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453652985",
            "telephone_number": "937-638-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E POPLAR ST",
            "address_2": "STE. 7",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453652985",
            "telephone_number": "937-638-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN OHIO PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PSYD",
        "authorized_official_telephone_number": "973-638-5210"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "7027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61000064",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wellspace Therapeutics, LLC
• Ivy Welsh
• Chloe Wenning
• Shanna M Wentz, RPH
• Molly Beth Westerheide, MS., OTR/L
• Western Ohio Psychological Services, LLC
• Deborah Michelle Wheeler
• Lynda L Wick, LPCC-SUPV
• John Joseph Wilding, D.O.
• Keith H Wiley

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.