Wayne Carlton Etheridge, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

04-019-PSY Issued in VI

Practice address

5030 Anchor Way
Christiansted, VI 00820-4692

Phone

(340) 773-7772

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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 and National Provider Directory roles.

• MJPT LLC

  • Physical Therapist
  • Christiansted, VI
  • NPI 1285275081
  NPD

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1609923713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26461",
            "city": "ST CROIX",
            "state": "VI",
            "postal_code": "008242461",
            "telephone_number": "340-719-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 ANCHOR WAY",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008204692",
            "telephone_number": "340-773-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERIDGE",
        "first_name": "WAYNE",
        "middle_name": "CARLTON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "VI",
            "license": "04-019-PSY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleanor Quinitchete Hyperbaric, Wound Care and Diagnostic Center, Inc
• Empath Psychological Services
• Maria Alicia Encarnacion, DC
• Maria Espinosa
• Estrat Usvi Inc. (Medix Caribe)
• Giselle Dizon Evora, NP
• Stanford L Fabio, D.D.S.
• Family Medicine Associates & Consultants
• Juliss Farrelly
• Chloe Anne Farris, LCSW

• Counseling Psychologist in Christiansted, VI
• Providers in Christiansted, VI by specialty
• Counseling Psychologist in U.S. Virgin Islands

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.