Individual provider Active NPI

Wendy Tatum, M.S., ED.S, NCSP

  • School Psychologist
  • Fredericksburg, VA
National Provider Identifier
1962701730
Registry record updated Mar 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
0803000233 Issued in VA
Practice address
503 Sophia St
Fredericksburg, VA 22401-6075
Phone
(540) 656-3114
Fax
(484) 842-6053
NPI assigned
Mar 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2011

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 0803000233 VA Primary

Addresses

Primary practice location

503 Sophia St
Fredericksburg, VA 22401-6075

Mailing address

711 Lakeview Pkwy
Locust Grove, VA 22508-5131

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)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Growth Therapies, LLC Past Accepting new patients
Wendy Carannante & Associates, PLLC School Past Accepting new patients
Neurofeedback and Brain Fitness Center, LLC School PastSince Sep 1, 2012 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1300492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300492800000",
    "number": "1962701730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 LAKEVIEW PKWY",
            "city": "LOCUST GROVE",
            "state": "VA",
            "postal_code": "225085131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 SOPHIA ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224016075",
            "telephone_number": "540-656-3114",
            "fax_number": "484-842-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "WENDY",
        "credential": "M.S., ED.S, NCSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-19",
        "last_updated": "2011-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "VA",
            "license": "0803000233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2011; 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.