Active NPI
Beth G Wildman, PHD
- Psychologist
- Cuyahoga Falls, OH
National Provider Identifier
1831287135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3224
- Practice address
- 96 Graham Road
Suite a
Cuyahoga Falls, OH 44223 - Phone
- (330) 929-1326
- Fax
- (330) 929-1327
- NPI assigned
- Oct 11, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3224 | OH | Primary |
Addresses
Primary practice location
96 Graham Road
Suite a
Cuyahoga Falls, OH 44223
Mailing address
96 Graham Road
Suite a
Cuyahoga Falls, OH 44223
Phone (930) 929-1326
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0819967 | Medicaid | OH |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3224 | OH | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831287135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 GRAHAM ROAD",
"address_2": "SUITE A",
"city": "CUYAHOGA FALLS",
"state": "OH",
"postal_code": "44223",
"telephone_number": "930-929-1326",
"fax_number": "330-929-1327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 GRAHAM ROAD",
"address_2": "SUITE A",
"city": "CUYAHOGA FALLS",
"state": "OH",
"postal_code": "44223",
"telephone_number": "330-929-1326",
"fax_number": "330-929-1327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDMAN",
"first_name": "BETH",
"middle_name": "G",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "3224",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0819967",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cuyahoga Falls, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.