Active NPI
Candice Shpiegelman Wanhatalo, PH.D.
- Clinical Psychologist
- Washington, DC
National Provider Identifier
1639318579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810004059
- Practice address
- 50 Irving St NW
Washington, DC 20422-0001 - Phone
- (202) 745-8000
- Fax
- (202) 745-8611
- NPI assigned
- Feb 17, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810004059 | VA | Primary |
Addresses
Primary practice location
50 Irving St NW
Washington, DC 20422-0001
Mailing address
10 North Greene Street
Baltimore, MD 21201
Phone (202) 745-8000
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810004059 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533686400000",
"number": "1639318579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 NORTH GREENE STREET",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21201",
"telephone_number": "202-745-8000",
"fax_number": "202-745-8611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 IRVING ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "204220001",
"telephone_number": "202-745-8000",
"fax_number": "202-745-8611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANHATALO",
"first_name": "CANDICE",
"middle_name": "SHPIEGELMAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-17",
"last_updated": "2018-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810004059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.