Danica Wailes, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2015033117 Issued in MO

Practice address

192 Expressway LN Ste 240
Branson, MO 65616-7122

Phone

(417) 597-4309

NPI assigned

Sep 24, 2015

Last updated

Sep 24, 2015By the provider in NPPES

Sex

Female

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midwest Assessment and Psychotherapy Solutions, PC

  • Clinical Psychologist
  • Springfield, MO
  • NPI 1275861809
  NPD (past)

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1649649245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 EXPRESSWAY LN STE 240",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167122",
            "telephone_number": "417-597-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 EXPRESSWAY LN STE 240",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167122",
            "telephone_number": "417-597-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAILES",
        "first_name": "DANICA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2015033117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald N Vespa, DDS
• Justin Brandon Virtue, PHARM D
• Nicholas Vogel
• Ashden Vogler-Blake, FNP
• Annette Vorhoff, APN
• Wal-Mart Stores East LP (Walmart Pharmacy 10-4381)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0032)
• Jaycie Lea Walden, M.S. SLP
• Walgreen Co (Walgreens #03594)
• Russell Keith Wall, D.D.S.

• Clinical Psychologist in Branson, MO
• Providers in Branson, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; 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.