Svenja Mirjam Wacker, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

002844 Issued in CT

Practice address

111 East Ave
Suite 313
Norwalk, CT 06851-5014

Phone

(203) 855-9691

Fax

(203) 855-7743

NPI assigned

Jun 27, 2007

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)

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.

• Laurel Chandler MD PLLC

  • Plastic Surgery Physician
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  • NPI 1073177184
  NPD (past)
• Neuropsychology Consultants, LLC

  • Clinical Neuropsychologist
  • Wilton, CT
  • NPI 1942208814
  NPD (past)

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1942407630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 EAST AVE",
            "address_2": "SUITE 313",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515014",
            "telephone_number": "203-855-9691",
            "fax_number": "203-855-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 EAST AVE",
            "address_2": "SUITE 313",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515014",
            "telephone_number": "203-855-9691",
            "fax_number": "203-855-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKER",
        "first_name": "SVENJA",
        "middle_name": "MIRJAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "002844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lauren Vivenzio, LCSW
• Vjones Enterprise LLC
• Yolanda Volcimus, PT
• Giselle Sacha Volney
• Anupama Voodarla, MD
• Katherine E Wade
• Eric Wagner, PA-C
• Jennifer Landon Wagner
• Sandra K. Wainwright, MD
• Wal-Mart Stores East LP

• Clinical Neuropsychologist in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Clinical Neuropsychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.