Wilbur Lewis Wadlington, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS004872L Issued in PA

Practice address

141 E Fairmount Ave
State College, PA 16801-5315

Phone

(814) 234-3464

Fax

(814) 237-6646

NPI assigned

Jun 7, 2007

Sex

Male

Sole proprietor

Yes

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

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.

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  • NPI 1760271068
  NPD (past)
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  • Community/Behavioral Health Agency
  • State College, PA
  • NPI 1740703636
  NPD (past)

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942403803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E FAIRMOUNT AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015315",
            "telephone_number": "814-234-3464",
            "fax_number": "814-237-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E FAIRMOUNT AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015315",
            "telephone_number": "814-234-3464",
            "fax_number": "814-237-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADLINGTON",
        "first_name": "WILBUR",
        "middle_name": "LEWIS",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS004872L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allison Wagner
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• Wagoner Chiropractic Inc
• Jay Frederick Wagoner, D.C.

• Psychologist in State College, PA
• Providers in State College, PA by specialty
• Psychologist in Pennsylvania

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