Individual provider Active NPI

Nancy Wonacott, PH.D., HSPP

  • Clinical Psychologist
  • Seymour, IN
National Provider Identifier
1598737884
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20041777A Issued in IN
Practice address
1443 Corporate Way
Seymour, IN 47274
Phone
(812) 522-4341
Fax
(812) 522-7910
NPI assigned
Feb 2, 2006
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20041777A IN Primary

Addresses

Primary practice location

1443 Corporate Way
Seymour, IN 47274

Mailing address

1 Kalisa Way Ste 101
Paramus, NJ 07652-3508
Phone (888) 948-6789

Other identifiers 2

IdentifierTypeStateIssuer
200401020AMedicaidIN
000000209033OtherINANTHEM PIN

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)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1598737884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KALISA WAY STE 101",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523508",
            "telephone_number": "888-948-6789",
            "fax_number": "877-345-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 CORPORATE WAY",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "47274",
            "telephone_number": "812-522-4341",
            "fax_number": "812-522-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONACOTT",
        "first_name": "NANCY",
        "credential": "PH.D., HSPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041777A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200401020A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000209033",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seymour, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.