DR. MARCIE C WISEMAN (NPI# 1225366172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225366172 |
| Entity Type | Individual |
| Full Name | DR. MARCIE C WISEMAN |
| Credential | PHD |
| Practice Address |
2704 N Oak St Building B-3 Valdosta GA 31602-1744 |
| Practice Telephone | 2292570100 |
| Mailing Telephone | 2292570100 |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2012-11-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY003561 | GA | Behavioral Health & Social Service Providers |
| Street Address |
2704 N OAK ST BUILDING B-3 |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-1744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669471926 | George P Pennington | Surgery | 2704 N Oak St, Valdosta, GA 31602-1744 | 2005-07-19 |
| 1821534033 | Laura Johnson | Speech-Language Pathologist | 2704 N Oak St, Unit K, Valdosta, GA 31602-1744 | 2017-01-11 |
| 1154878866 | Daniel Haney | Nurse Practitioner | 2704 N Oak St, Suite B-3, Valdosta, GA 31602-1744 | 2016-09-10 |
| 1740678663 | Bessie R Caquelard | Speech-Language Pathologist | 2704 N Oak St, Bldg A-2, Valdosta, GA 31602-1744 | 2014-12-30 |
| 1396097325 | Britini L Holder | Speech-Language Pathologist | 2704 N Oak St, Bldg K, Valdosta, GA 31602-1744 | 2012-10-15 |
| 1679876858 | Bethany E Dollar | Social Worker | 2704 N Oak St, Building B-3, Valdosta, GA 31602-1744 | 2010-12-10 |
| 1134429582 | Radiology Associates of Valdosta, LLC | Radiology | 2704 N Oak St, Bldg E, Valdosta, GA 31602-1744 | 2010-11-01 |
| 1376771113 | Mccowan Surgical Associates | Surgery | 2704 N Oak St, Suite A2, Valdosta, GA 31602-1744 | 2009-07-01 |
| 1275725137 | John B. Hunt, M.d., P.C. | General Practice | 2704 N Oak St, Building A-2, Valdosta, GA 31602-1744 | 2007-08-15 |
| 1477680973 | South Georgia Psychiatric & Counseling Center | Counselor | 2704 N Oak St, Building B-3, Valdosta, GA 31602-1744 | 2007-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| 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 |
|---|---|---|---|---|
| 1548771876 | Aldo Enrique Revilla | Psychologist | Bermiss Rd, Moody Afb, Valdosta, GA 31699 | 2017-10-13 |
| 1588194799 | Ryan Couillou | Psychologist | 2704 N Oak St Bldg A1, Valdosta, GA 31602-5901 | 2017-06-20 |
| 1447677828 | Twyla Lucinda Mancil | Psychologist | 202 W Gordon St, Suite D, Valdosta, GA 31601-4569 | 2014-03-24 |
| 1881874618 | Kellie Hyde | Psychologist | 5140 Northwind Blvd, Condo 305 East, Valdosta, GA 31605-4506 | 2007-11-08 |
| 1720003262 | David Thomas Wasieleski | Psychologist | 1002 Slater St, Valdosta, GA 31601-3937 | 2006-07-13 |
| 1790240984 | Jennifer Michelle Branscome | Psychologist | 2236 Bemiss Rd, Valdosta, GA 31602-1942 | 2019-02-01 |
| 1164870408 | Southern Psychological and Behavioral Services, LLC | Psychologist | 202 W Gordon St, Suite D, Valdosta, GA 31601-4569 | 2016-05-26 |
| 1750632279 | Palmtree Psychological Services, LLC | Psychologist | 111 Woodrow Wilson Dr, Suite B, Valdosta, GA 31602-2587 | 2012-09-24 |
| 1962516625 | Emily Burton | Psychologist | 2841 N Patterson St, Valdosta, GA 31602-1743 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568072015 | Karen A Foster | Psychologist | 2115 Dee Dee Muse Ln Nw, Atlanta, GA 30318-1503 | 2020-08-08 |
| 1013525120 | Renato Popovic | Psychologist | 2601 Cross Country Dr, Columbus, GA 31906-1801 | 2020-07-15 |
| 1275159584 | Joe Ann Marie Brandt | Psychologist | 11706 Mercy Blvd Ste 1, Savannah, GA 31419-1751 | 2020-06-23 |
| 1376164863 | Alexander Brikman | Psychologist | 2374 Main St Ste A, Tucker, GA 30084-4533 | 2020-05-06 |
| 1154942084 | Martie Camille Belle | Psychologist | 1462 Clifton Rd Ne Ste 235, Atlanta, GA 30322-1063 | 2020-05-01 |
| 1518513738 | Narjerah Delk | Psychologist | 1226 Anchor Ter Sw, Atlanta, GA 30311-3402 | 2019-08-13 |
| 1043862907 | Lauren Barbara Mcsweeney | Psychologist | 12 Executive Park Dr Ne Ste 3000, Atlanta, GA 30329-2206 | 2019-07-11 |
| 1356907695 | Mc Medical LLC | Psychologist | 3615 Charles Hardy Pkwy Ste 200, Dallas, GA 30157-9472 | 2019-05-13 |
| 1851853758 | Charles A Helm | Psychologist | 116 Preston Landing Cir, Lithia Springs, GA 30122-6846 | 2019-04-01 |
| 1194285106 | Heather Ansari | Psychologist | 3715 Northside Pkwy Nw Ste 605, Atlanta, GA 30327-2886 | 2019-03-25 |
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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.