Malinda Carol Wilczynski, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2005027404 Issued in MO

Practice address

411 3Rd St
Monett, MO 65708-2008

Phone

(417) 476-1000

Fax

(417) 476-1082

NPI assigned

Feb 19, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Clark Community Mentalhealth Center

  • Children's Substance Abuse Rehabilitation Facility
  • Monett, MO
  • NPI 1912337692
  NPD (past)
• Ozark Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Joplin, MO
  • NPI 1790796878
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1629112925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "PIERCE CITY",
            "state": "MO",
            "postal_code": "657232100",
            "telephone_number": "417-476-1000",
            "fax_number": "417-476-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 3RD ST",
            "city": "MONETT",
            "state": "MO",
            "postal_code": "657082008",
            "telephone_number": "417-476-1000",
            "fax_number": "417-476-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCZYNSKI",
        "first_name": "MALINDA",
        "middle_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2005027404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Monett, MO
• Providers in Monett, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.