Active NPI
Roger Wyland, LCSW
- Clinical Social Worker
- Williamsport, PA
National Provider Identifier
1790776631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW016957
- Practice address
- 501 E 3Rd St
Williamsport, PA 17701-5316 - Phone
- (570) 323-7535
- NPI assigned
- Oct 31, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW016957 | PA | Primary |
Addresses
Primary practice location
501 E 3Rd St
Williamsport, PA 17701-5316
Mailing address
501 E 3Rd St
Williamsport, PA 17701-5316
Phone (570) 323-7535
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW016957 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442361600000",
"number": "1790776631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 E 3RD ST",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177015316",
"telephone_number": "570-323-7535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 E 3RD ST",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177015316",
"telephone_number": "570-323-7535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYLAND",
"first_name": "ROGER",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-31",
"last_updated": "2015-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW016957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.