Active NPI
David S Wood, PH.D.
- Counseling Psychologist
- Provo, UT
National Provider Identifier
1861618134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 7318482-2501
- Practice address
- 1190 N 900 E
Provo, UT 84604-3536 - Phone
- (801) 422-7620
- Fax
- (801) 422-0165
- NPI assigned
- Apr 17, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 7318482-2501 | UT | Primary |
| Clinical Psychologist | 103TC0700X | 071.007348 | IL |
Addresses
Primary practice location
1190 N 900 E
Provo, UT 84604-3536
Mailing address
4722 Country Club Dr
Highland, UT 84003-9525
Phone (801) 703-7593
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 |
|---|---|---|---|
| 071.007348 | IL | MD | Clinical Psychologist |
| 7318482-2501 | UT | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337126400000",
"number": "1861618134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4722 COUNTRY CLUB DR",
"city": "HIGHLAND",
"state": "UT",
"postal_code": "840039525",
"telephone_number": "801-703-7593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1190 N 900 E",
"city": "PROVO",
"state": "UT",
"postal_code": "846043536",
"telephone_number": "801-422-7620",
"fax_number": "801-422-0165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "DAVID",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2012-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "UT",
"license": "7318482-2501",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.007348",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.