IndividualActive
Justin Wiseman, PSY.D.
NPI 1073159539 · Clinical Psychologist · Kansas City, MO
Provider details
- NPI number
- 1073159539
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PSY.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 2018037238 (MO)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(74/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
4 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
401 E 19th St Apt 1405
Kansas City, MO 64108-1791
Phone: (314) 255-9594
Street-level locationGet directions
Mailing address
401 E 19th St Apt 1405
Kansas City, MO 64108-1791
Additional practice locations (3)
- 1300 Metropolitan AveLeavenworth, KS 66048-1254Phone: (314) 255-9594
- 303 N Stadium Blvd Ste 200Columbia, MO 65203-1429Phone: (314) 255-9594
- 600 E 5th StFulton, MO 65251-1753Phone: (573) 592-4100
Registry dates
- Enumerated
- 2019-11-20
- Last updated
- 2021-03-24
- Certified
- 2021-03-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.