Vicky Wolfe, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY10802 Issued in FL

Practice address

203 Hollywood Blvd NE
Fort Walton Beach, FL 32548-5775

Phone

(850) 226-7666

NPI assigned

Jul 8, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bayer Neurobehavioral Center, PLLC

  • Clinical Neuropsychologist
  • Fort Walton Beach, FL
  • NPI 1720470255
  NPD

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1912525866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 VINE AVE NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 HOLLYWOOD BLVD NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485775",
            "telephone_number": "850-226-7666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Vine Ave NE",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325485069",
            "country_code": "US",
            "telephone_number": "850-226-7666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "VICKY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY10802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Renee Wise, LMHC
• Matthew Wisniewski, PTA
• Andrea J Witt, CRNA
• Gavin Payne Wolfe
• Tade L Wolfe, MA, CCC-SLP
• Megan Wolter, BCBA
• Carolyn V Woo, RPH
• Jean Woo, D.D.S.
• Hayley C Woods, RN
• Takeda L. Woods, LPN

• Clinical Child & Adolescent Psychologist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Clinical Child & Adolescent Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.