Mary Josephine Wiencken, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7803 Issued in TN

Practice address

3180 Professional PLZ Ste 101
Germantown, TN 38138-1534

Phone

(901) 328-2104

NPI assigned

Feb 13, 2023

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)

Not enrolled

Credentials

Master of Science

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.

• Parit Mortem Speech and Language

  • Speech-Language Pathologist
  • Bartlett, TN
  • NPI 1699588491
  NPD Authorized official
• Hopebridge LLC

  • Child & Adolescent Psychiatry Physician
  • Brentwood, TN
  • NPI 1881352177

  Speech-Language Pathologist

  NPD (past)
• JH & Associates, LLC

  dba Janna Hacker and Associates

  • Speech-Language Pathologist
  • Germantown, TN
  • NPI 1972808301
  NPD (past)

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1730886409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 PROFESSIONAL PLZ STE 101",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381534",
            "telephone_number": "901-328-2104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 Schilling Blvd E Ste 112",
            "address_purpose": "LOCATION",
            "city": "Collierville",
            "state": "TN",
            "postal_code": "380177078",
            "country_code": "US",
            "telephone_number": "901-424-5621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIENCKEN",
        "first_name": "MARY",
        "middle_name": "JOSEPHINE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "7803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wholeheart Women's Christian Counseling Inc.
• Wholeheart Women's Christian Counseling PLLC
• Elizabeth Warren Wickliffe
• Christen Wiedower, FNP
• Eric R. Wiedower, DO
• Robert A Wiener, MD
• Mary Beth Wiggins, LCSW
• Rance Ballard Wilbourn, MD
• Sara E Wiles, FNP
• Laura Lynn Wilkinson, OTR/L

• Speech-Language Pathologist in Germantown, TN
• Providers in Germantown, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.