Jacqueline W Wynn, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

P.5677 Issued in OH

Practice address

189 W Schrock Rd
Westerville, OH 43081-2890

Phone

(614) 355-7500

Fax

(614) 355-7533

NPI assigned

Jul 24, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Nationwide Children'S Hospital

  • Durable Medical Equipment & Medical Supplies
  • Columbus, OH
  • NPI 1447061262
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1730101437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052639",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 W SCHROCK RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430812890",
            "telephone_number": "614-355-7500",
            "fax_number": "614-355-7533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 E Main St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432155369",
            "country_code": "US",
            "telephone_number": "614-355-6340",
            "fax_number": "614-355-6347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "195 W Schrock Rd",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430812890",
            "country_code": "US",
            "telephone_number": "614-355-7570",
            "fax_number": "614-355-7580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYNN",
        "first_name": "JACQUELINE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OH",
            "license": "P.5677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0121355",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jarrod Wurm
• Karlie Wurm, OTR/L
• Allison Wyatt, MS, BCBA
• Minna Wybrecht, MD
• Amy Joy Wynia
• Jennifer L Wyse, MD
• Momoko Yamashita
• Heather Lynn Yates, CPNP
• Katherine Ann Yates, MD
• Alexander Yau

• Clinical Child & Adolescent Psychologist in Westerville, OH
• Providers in Westerville, OH by specialty
• Clinical Child & Adolescent Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.