Dr David Charles Wiesner, | |
2610 Wycliff Rd, Suite 103, Raleigh, NC 27607-3073 | |
(919) 782-4060 | |
(919) 782-0906 |
Full Name | Dr David Charles Wiesner |
---|---|
Gender | Male |
Speciality | Clinical Psychologist |
Experience | 39 Years |
Location | 2610 Wycliff Rd, Raleigh, North Carolina |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265410286 | NPI | - | NPPES |
04080 | Other | NC | BC/BS PROVIDER NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | PY60405036 (Washington) | Primary |
103T00000X | Psychologist | 2039 (North Carolina) | Secondary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Emmaus Counseling Service Ps | 5193726701 | 16 |
Entity Name | Emmaus Counseling Service Ps |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548321789 PECOS PAC ID: 5193726701 Enrollment ID: O20070125000054 |
Mailing Address | Practice Location Address |
---|---|
Dr David Charles Wiesner, 8290 165th Ave Ne, Redmond, WA 98052-3948 Ph: (425) 869-2644 | Dr David Charles Wiesner, 2610 Wycliff Rd, Suite 103, Raleigh, NC 27607-3073 Ph: (919) 782-4060 |
Mrs. Betty-shannon Prevatt, M.A., LPA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2601 Lake Dr, Suite 103, Raleigh, NC 27607 Phone: 919-612-3348 Fax: 919-782-1399 | |
Joel Harris, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 6901 Three Bridges Cir, Raleigh, NC 27613 Phone: 910-398-0188 Fax: 814-377-0185 | |
Mrs. Shelley T. Kraft, LPA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 312 W Millbrook Rd, Suite 109, Raleigh, NC 27609 Phone: 919-845-9977 Fax: 919-845-9761 | |
Dr. Benjamin David Reese Jr., PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 8524 Six Forks Rd, Raleigh, NC 27615 Phone: 919-824-0768 | |
Mrs. Alisa F Dawson, LPA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4904 Waters Edge Dr Ste 154, Raleigh, NC 27606 Phone: 919-533-8726 | |
Jalisa Maynard, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1520 Beacon Ridge Ct, Raleigh, NC 27610 Phone: 919-720-3819 | |
Dr. Lise Leigh Osvold, PH.D., L.P. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5500 Mcneely Dr, Suite 101, Raleigh, NC 27612 Phone: 919-787-1240 Fax: 919-787-1241 |