Active NPI
Wendy Clyne, PSYD
- Clinical Psychologist
- Aurora, CO
National Provider Identifier
1801985064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1383
- Practice address
- 12605 E 16TH Ave
Aurora, CO 80045-2545 - Phone
- (720) 848-1980
- Fax
- (303) 400-5051
- NPI assigned
- Oct 12, 2006
- Last updated
- Jul 21, 2022
- Sex
- Female
- 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 Psychologist | 103TC0700X | 1383 | CO | Primary |
Addresses
Primary practice location
12605 E 16TH Ave
Aurora, CO 80045-2545
Mailing address
PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07000904 | Medicaid | CO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1383 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1801985064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 110429",
"city": "AURORA",
"state": "CO",
"postal_code": "800420429",
"telephone_number": "303-493-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12605 E 16TH AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800452545",
"telephone_number": "720-848-1980",
"fax_number": "303-400-5051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLYNE",
"first_name": "WENDY",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "1383",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07000904",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.