Active NPI
Linda Wakefield, PHD
- Psychologist
- Mooresville, IN
National Provider Identifier
1992771570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 19110111A
- Practice address
- 11370 N State Road 67
Mooresville, IN 46158-6368 - Phone
- (317) 834-8187
- Fax
- (317) 834-8196
- NPI assigned
- Feb 24, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 19110111A | IN | Primary |
Addresses
Primary practice location
11370 N State Road 67
Mooresville, IN 46158-6368
Mailing address
645 S Rogers St
Bloomington, IN 47403-2353
Phone (812) 339-1691
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19110111A | IN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centerstone of Indiana, Inc. | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bloomington, IN
- NPI 1972320224
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241395200000",
"number": "1992771570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "645 S ROGERS ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032353",
"telephone_number": "812-339-1691",
"fax_number": "812-339-8109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11370 N STATE ROAD 67",
"city": "MOORESVILLE",
"state": "IN",
"postal_code": "461586368",
"telephone_number": "317-834-8187",
"fax_number": "317-834-8196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKEFIELD",
"first_name": "LINDA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-24",
"last_updated": "2009-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "19110111A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.