Active NPI
Robert John Wancha Jr., M.A.
- Clinical Psychologist
- Ann Arbor, MI
National Provider Identifier
1942481403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301008343
- Practice address
- 2010 Hogback Rd
Suite 7
Ann Arbor, MI 48105-9749 - Phone
- (734) 677-0918
- NPI assigned
- Nov 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 6301008343 | MI | Primary |
Addresses
Primary practice location
2010 Hogback Rd
Suite 7
Ann Arbor, MI 48105-9749
Mailing address
PO Box 1089
Garden City, MI 48136-1089
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301008343 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apex Behavioral Health PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Ann Arbor, MI
- NPI 1518154269
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196035200000",
"number": "1942481403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1089",
"city": "GARDEN CITY",
"state": "MI",
"postal_code": "481361089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 HOGBACK RD",
"address_2": "SUITE 7",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481059749",
"telephone_number": "734-677-0918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANCHA",
"first_name": "ROBERT",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-26",
"last_updated": "2007-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301008343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.