Individual provider Active NPI

Markita Wolf, PSY.D.

  • Clinical Psychologist
  • Midlothian, VA
National Provider Identifier
1760790489
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810004734 Issued in VA
Practice address
831 Grove Rd Ste C
Midlothian, VA 23114
Phone
(804) 743-0960
NPI assigned
Sep 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X
Forensic Psychologist 103TF0200X 0810004734 VA
Clinical Psychologist 103TC0700X 0810004734 VA Primary
Addiction (Substance Use Disorder) Psychologist 103TA0400X

Addresses

Primary practice location

831 Grove Rd Ste C
Midlothian, VA 23114

Mailing address

7501 Lady Blair LN
North Chesterfield, VA 23236-5074

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810004734VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1760790489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 LADY BLAIR LN",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232365074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 GROVE RD STE C",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23114",
            "telephone_number": "804-743-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "MARKITA",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "VA",
            "license": "0810004734",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004734",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

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

Verify at the official NPI Registry.