Active NPI
Karl Lawrence Wissemann, PHD
- Clinical Psychologist
- Nashville, TN
National Provider Identifier
1881495018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY10000865
- Practice address
- 1310 24TH Ave S
Nashville, TN 37212-2637 - Phone
- (615) 873-7628
- NPI assigned
- Mar 24, 2025
- 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 Psychologist | 103TC0700X | PSY10000865 | MA | Primary |
Addresses
Primary practice location
1310 24TH Ave S
Nashville, TN 37212-2637
Mailing address
759 Franklin St
Worcester, MA 01604-1730
Phone (631) 560-3356
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 |
|---|---|---|---|
| PSY10000865 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742774400000",
"number": "1881495018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "759 FRANKLIN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016041730",
"telephone_number": "631-560-3356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 24TH AVE S",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372122637",
"telephone_number": "615-873-7628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISSEMANN",
"first_name": "KARL",
"middle_name": "LAWRENCE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-24",
"last_updated": "2025-03-24",
"certification_date": "2025-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "PSY10000865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.