| Wilson Psychological Associates Pllc | |
|
501 S Johnstone Ave Suite 503 Bartlesville OK 74003-6622 | |
| (918) 337-6050 | |
| (918) 337-6061 |
| Full Name | Wilson Psychological Associates Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 501 S Johnstone Ave, Bartlesville, Oklahoma |
| Authorized Official Name and Position | Kenneth Spencer Wilson (PSYCHOLOGIST) |
| Authorized Official Contact | 9183376050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilson Psychological Associates Pllc 501 S Johnstone Ave Suite 503 Bartlesville OK 74003-6622 Ph: (918) 337-6050 | Wilson Psychological Associates Pllc 501 S Johnstone Ave Suite 503 Bartlesville OK 74003-6622 Ph: (918) 337-6050 |
| NPI Number | 1144326265 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 09/21/2023 |
| Medicare PECOS PAC ID | 7113907452 |
|---|---|
| Medicare Enrollment ID | O20040726000640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144326265 | NPI | - | NPPES |
| 200522095 | Other | OK | MEDICARE NUMBER |
| 200029610A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 966 (Oklahoma) | Primary |
| Provider Name | Kenneth Spencer Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366400707 PECOS PAC ID: 6002896347 Enrollment ID: I20040727000424 |
| Provider Name | Kimberly Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902277742 PECOS PAC ID: 6800197591 Enrollment ID: I20151222002756 |
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