Individual provider Active NPI

Wendy Elese Waithe Simmons, PH.D.

  • School Psychologist
  • New Haven, CT
National Provider Identifier
1922291368
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
002791 Issued in CT
Practice address
441 Orange St
New Haven, CT 06511-6217
Phone
(203) 824-2464
NPI assigned
Aug 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 002791 CT Primary

Addresses

Primary practice location

441 Orange St
New Haven, CT 06511-6217

Mailing address

441 Orange St
New Haven, CT 06511-6217
Phone (203) 824-2464

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

LicenseStateTypeSpecialty
002791CTMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1922291368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 ORANGE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116217",
            "telephone_number": "203-824-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 ORANGE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116217",
            "telephone_number": "203-824-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "WENDY",
        "middle_name": "ELESE WAITHE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CT",
            "license": "002791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.

Verify at the official NPI Registry.