Wings of Freedom Psychological Care PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

WINGS OF FREEDOM PSYCHOLOGICAL CARE PLLC

Practice address

2514 Biddle Ave
Wyandotte, MI 48192-7891

Phone

(248) 444-7891

NPI assigned

Nov 10, 2019

Organization subpart

No

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

Authorized official

Name

Amelia Rivas, MS, LLP, PLLC

Title

Clinical Psychologist

Phone

(248) 444-7378

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1573344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573344000000",
    "number": "1790320091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 DEMEAN ST",
            "city": "MELVINDALE",
            "state": "MI",
            "postal_code": "481221623",
            "telephone_number": "248-444-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481927891",
            "telephone_number": "248-444-7891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINGS OF FREEDOM PSYCHOLOGICAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-10",
        "last_updated": "2019-11-10",
        "status": "A",
        "authorized_official_last_name": "RIVAS",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "248-444-7378",
        "authorized_official_credential": "MS, LLP, PLLC"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordyn Wiedyke, OTD, OTR/L
• Jill E Wiesenberger, D.O.
• Kathleen Ann Wilkins, RD
• Rachel Williams, DO
• Desaraea Wilson
• Leroy F Wojewodzic, D.D.S.
• Debra M. Wojno, RD
• Karen Wolak, IBCLC
• David L Wolf, D.O.
• Jason Wong, DO

• Clinical Psychologist in Wyandotte, MI
• Providers in Wyandotte, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2019; 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.