Individual provider Active NPI

Lisa A. Wuyek, PH.D.

  • Clinical Psychologist
  • Baltimore, MD
National Provider Identifier
1780833137
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
04493 Issued in MD
Practice address
600 Wyndhurst Ave
Suite 245-D
Baltimore, MD 21210-2489
Phone
(443) 376-5946
Fax
(443) 438-3056
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 04493 MD Primary

Addresses

Primary practice location

600 Wyndhurst Ave
Suite 245-D
Baltimore, MD 21210-2489

Mailing address

600 Wyndhurst Ave
Suite 245-D
Baltimore, MD 21210-2489
Phone (443) 376-5946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2013 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
04493MDMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360800000000",
    "number": "1780833137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WYNDHURST AVE",
            "address_2": "SUITE 245-D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212102489",
            "telephone_number": "443-376-5946",
            "fax_number": "443-438-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WYNDHURST AVE",
            "address_2": "SUITE 245-D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212102489",
            "telephone_number": "443-376-5946",
            "fax_number": "443-438-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUYEK",
        "first_name": "LISA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2013-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.