DR. CAROLYN J. WYATT


Address: 814 S Washington St, Moscow, ID 83843-3049
Phone: 2088830619

DR. CAROLYN J. WYATT (NPI# 1437139607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437139607
Entity Type Individual
Full Name DR. CAROLYN J. WYATT
Credential PH.D.
Practice Address 814 S Washington St
Moscow
ID 83843-3049
Mailing Address 280 Hayward Rd
Pullman
WA 99163-8949
Practice Telephone 2088830619
Practice Fax Number 2088824774
Mailing Telephone 5093326417
Mailing Fax Number 5093326417
Enumeration Date 2006-01-22
Last Update Date 2011-10-31
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103TC1900X Psychologist
Specialization: Counseling
#1017 WA Behavioral Health & Social Service Providers
Y 103TC1900X Psychologist
Specialization: Counseling
PSY-188 ID Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
ID REGENCE BLUE SHIELD 000010015935 01
ID PREMERA BLUE CROSS 145779137335 01
ID BLUE CROSS OF IDAHO 8D236 01

Other Providers CAROLYN WYATT

NPI Name Taxonomy Address Enumeration
1316999840 Carolyn Wyatt Family Medicine 8808 Centre Park Dr, Suite 206, Columbia, MD 21045-2126 2006-05-16
1558809525 Carolyn Wyatt Behavioral Analyst 1706 E Broad St, Columbus, OH 43203 2017-02-09
1659699569 Carolyn Marie Wyatt Nurse Practitioner 333 Laws Ave, Ukiah, CA 95482-6540 2010-05-17
1104095223 Carolyn A Wyatt Audiologist 8218 Wisconsin Ave, Suite 106, Bethesda, MD 20814-3107 2008-02-22

Office Location

Street Address 814 S WASHINGTON ST
City MOSCOW
State ID
Zip Code 83843-3049

Providers in the same location

NPI Name Taxonomy Address Enumeration
1881699536 Beth Waddel Psychologist 814 S Washington St, Moscow, ID 83843-3049 2005-06-18
1720396252 Chia-chi Hu Psychologist 814 S Washington St, Moscow, ID 83843-3049 2010-09-17
1164543666 Kathy Lynn Kwiatkowski Counselor 814 S Washington St, Moscow, ID 83843-3049 2007-04-02
1376688895 Karen Alice Knoff Counselor 814 S Washington St, Moscow, ID 83843-3049 2007-02-21
1174533525 Alan J. Whitlock Psychologist 814 S Washington St, Moscow, ID 83843-3049 2006-08-08
1396762043 Diana L Pals Counselor 814 S Washington St, Moscow, ID 83843-3049 2006-07-17
1336106830 Dianne Ladon Phillips-miller Psychologist 814 S Washington St, Moscow, ID 83843-3049 2006-04-27
1902808736 Dave Potter Counselor 814 S Washington St, Moscow, ID 83843-3049 2005-08-11

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1033726880 Moscow Physical Therapy, LLC Clinic/Center 1174 Alturas Drive, Suite 2, Moscow, ID 83843 2020-09-25
1831703057 Hydee Flishaw Tubbs Becker Dietitian, Registered 614 North Hayes Street, Moscow, ID 83843 2020-09-04
1528626959 Ryan Steven Clark Student in an Organized Health Care Education/Training Program 212 Farm Road, #201, Moscow, ID 83843 2019-05-31
1770141384 Lingwen Zhang Specialist/Technologist 901 Paradise Creek Rd, Moscow, ID 83843 2019-05-30
1306363478 Elizabeth Campbell Dietitian, Registered 611 S. Main, Moscow, ID 83843 2017-08-29
1598285496 Gina Cretser Counselor 212 Rodeo Dr. #410, Moscow, ID 83843 2017-06-21
1124558721 Morgan Leigh Derloshon Specialist/Technologist 275 Southview Ave, Apt 206, Moscow, ID 83843 2017-06-15
1619411790 Kaylene Howard Massage Therapist 127 South Washington, Suite 6, Moscow, ID 83843 2016-12-08
1407237043 Jacob Kent Christensen Family Medicine 831 S Ash St, Moscow, ID 83843 2015-06-09
1366851388 Elisabeth Henry Pharmacist 2740 West Pullman Rd, Moscow, ID 83843 2014-08-04
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Taxonomy Information

Taxonomy Code 103TC1900X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Counseling

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649764713 Clarissa Marie Edge Richardson Psychologist University of Idaho Student Health Center 210, Moscow, ID 83844-0001 2018-06-21
1073748950 Nancy Sasse Sasser Psychologist 1060 Showalter Rd, Moscow, ID 83843-9199 2009-05-21
1720396252 Chia-chi Hu Psychologist 814 S Washington St, Moscow, ID 83843-3049 2010-09-17
1174533525 Alan J. Whitlock Psychologist 814 S Washington St, Moscow, ID 83843-3049 2006-08-08
1336106830 Dianne Ladon Phillips-miller Psychologist 814 S Washington St, Moscow, ID 83843-3049 2006-04-27

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1538583869 Meier Clinics of California Psychologist 360 East Avenue, Suite 200, Ketchum, ID 83340 2014-02-06
1841542982 Jeffrey Lee Elder II Psychologist 2335 Robison Dr, Rexburg, ID 83440-3310 2012-10-14
1336477207 Rd Boardman Psychologist Health Services 1529 Belmont St, Boise, ID 83725-0001 2009-12-03
1578732293 Melissa A Boley Psychologist 333 South Main St Ste 104, Ketchum, ID 83340 2008-02-27
1336361336 Jon E. Ashton Psychologist 2273 East Gala, Suite 100, Meridian, ID 83642-7289 2007-05-02
1184741282 Gregory W. Mondin Psychologist 220 W State St, Boise, ID 83702-6052 2007-03-23
1528105624 Laura Mckee Psy D L L C Psychologist 158 North 1st East Street, Driggs, ID 83422 2007-01-30
1619025251 Dale Arlan Babcock Psychologist 1500 West Barrett Drive, Meridian, ID 83642 2007-01-08
1942368253 Carl D. Haugen Psychologist 102 S 1st Ave Ste 202, Sandpoint, ID 83864-1398 2006-12-05
1124191895 Laura Mckee Psychologist 158 North First East Street, Driggs, ID 83422 2006-11-17
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Competitor

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City MOSCOW
Zip Code 83843

Improve Information

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Dataset Information

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.

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