JOHN A WILDER (NPI# 1164517819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164517819 |
| Entity Type | Individual |
| Full Name | JOHN A WILDER |
| Other Name | JAY WILDER |
| Credential | PH.D. |
| Practice Address |
14818 Capricorn Ln Charlotte NC 28277-2927 |
| Mailing Address |
13575 58th St N Suite 187 Clearwater FL 33760-3740 |
| Practice Telephone | 7045172138 |
| Mailing Telephone | 8006326074 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 3005 | NC | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
P3005 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | RR MEDICARE # - PARADIGM | P00316181 | 01 |
| NC | 6000785 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164059416 | John Nicholas Wilder | Student in an Organized Health Care Education/Training Program | Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219 | 2020-03-26 |
| Street Address |
14818 CAPRICORN LN |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277-2927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
| 1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
| 1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
| 1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
| Find all providers in zip 28277 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720698939 | Blue Ridge Behavior Systems Inc | Psychologist | 16147 Lancaster Hwy Ste 110, Charlotte, NC 28277-4196 | 2020-08-03 |
| 1689297921 | David B Spano | Psychologist | 3205 N Mcdowell St, Charlotte, NC 28205-1552 | 2020-05-21 |
| 1447721055 | Alexis Brightman, Pllc | Psychologist | 1914 J N Pease Pl Ste 172, Charlotte, NC 28262-4504 | 2018-12-07 |
| 1366920712 | Robbie Mae & Associates, LLC | Psychologist | 4020 Lakota Ct, Charlotte, NC 28269-4074 | 2018-07-29 |
| 1295222347 | Kathleen Lucey Hack | Psychologist | 9617 Runswyck Ct, Charlotte, NC 28269-8393 | 2018-04-15 |
| 1285133405 | Jill Pratt | Psychologist | 447 S Sharon Amity Rd Ste 140, Charlotte, NC 28211-2888 | 2018-02-02 |
| 1467847426 | Marguerita Sitrin Blaker | Psychologist | 2400 Crownpoint Executive Drive, Suite 100, Office #5, Charlotte, NC 28227 | 2015-04-06 |
| 1699193672 | Elizabeth Ann Peterson-vita | Psychologist | 700 East Stonewall Street, Suite 714, Charlotte, NC 28202 | 2014-04-07 |
| 1093137093 | Epiphany Integrated Care Services, LLC | Psychologist | 4921 Albemarle Rd, Suite 203, Charlotte, NC 28205-6654 | 2014-01-09 |
| 1568891588 | Terrence Schofield | Psychologist | 6060 Piedmont Row Dr S Ste 120, Charlotte, NC 28287-2801 | 2013-11-12 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.