Kaylie Wiseman

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

06622 Issued in MD

Practice address

1708 W Rogers Ave
Baltimore, MD 21209-4545

Phone

(410) 578-8600

NPI assigned

Apr 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1881190999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 D ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200032710",
            "telephone_number": "360-223-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 W ROGERS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094545",
            "telephone_number": "410-578-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "KAYLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "06622",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannel Elizabeth Wise, LMSW
• Sharvay Jasmine Wise
• Arlene Wiseman, PHARM.D.
• Deanna Jean Wiseman, MSN, RN
• Hilary Wiseman, MPH, LGSW
• Michal Wiseman, MD
• Nicholas Wiseman
• Tamara Wiseman
• Robert William Wisner-Carlson, M.D.
• Amanda Catherine Wisniewski, LMSW

• Clinical Psychologist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.