MOLLY WICKENHAUSER PHD
NPI 1538711189
Psychologist - Clinical in Saint Louis, MO

Q: What is Molly Wickenhauser's NPI number?

The NPI number for Molly Wickenhauser is 1538711189. It was assigned to this individual provider in the NPPES registry on July 14, 2019.

Q: What is Molly Wickenhauser's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Molly Wickenhauser enrolled in Medicare?

No. Molly Wickenhauser has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since July 14, 2019Opted out of Medicare · through Jan 1, 2028

915 N GRAND BLVD, SAINT LOUIS, MO 63106(314) 652-4100 Get Directions Write a Review

NPPES record last updated: April 11, 2024. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Apr 11, 2024, Jul 14, 2019 (2 updates tracked since 2019).

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About Molly Wickenhauser Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOLLY WICKENHAUSER PHD (NPI 1538711189) is an individual clinical provider in Saint Louis, Missouri, licensed in Illinois (071011123) and active in the NPI registry since July 2019. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1538711189

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameMOLLY WICKENHAUSERCredential: PHD

Location Address915 N GRAND BLVDSaint Louis, MO 63106-1621

Mailing Address915 N Grand BlvdSaint Louis, MO 63106-1621 · (314) 289-7671

Phone(314) 652-4100

Sole ProprietorNo

Enumeration DateJuly 14, 2019

Last NPPES UpdateApril 11, 20242 updates tracked since enumeration

NPPES CertifiedApril 11, 2024

✔ NPI 1538711189 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in IL · 071011123

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

915 N GRAND BLVD, Saint Louis, MO 63106

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Molly Wickenhauser Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2026 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2026

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MATTHEW CHRISTOPHER SIMPSON O.D.

Optometrist

915 N GRAND BLVD
SAINT LOUIS, MO 63106

St. Louis City (314) 652-4100

MS. CHARMIN MEYATTA GIBSON M.S.W.

Social Worker

915 N GRAND BLVD
SAINT LOUIS, MO 63106

St. Louis City (314) 652-4110

CONOR MCCARTNEY M.D.

Internal Medicine

915 N GRAND BLVD
SAINT LOUIS, MO 63106

St. Louis City (314) 652-4100

ALITA BILLOPS CNP

Nurse Practitioner (Primary Care)

915 N GRAND BLVD
SAINT LOUIS, MO 63106

St. Louis City (314) 652-4100

STEPHANIE ADAMS

Registered Nurse

915 N GRAND BLVD
SAINT LOUIS, MO 63106

St. Louis City (314) 289-7676

NAGLA ABDELMALEK M.D.

Emergency Medicine

915 N GRAND BLVD
SAINT LOUIS, MO 63106

St. Louis City (314) 652-4100

DR. JAMES MICHAEL HASIK DDS

Dentist (General Practice)

915 N GRAND BLVD, DENTAL CLINIC
SAINT LOUIS, MO 63106

St. Louis City (314) 652-4100

MS. TRACY LANES CRNA

Nurse Anesthetist, Certified Registered

915 N GRAND BLVD
SAINT LOUIS, MO 63106

St. Louis City (314) 652-4100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Molly Wickenhauser's NPI number?

The NPI number for Molly Wickenhauser is 1538711189. It was assigned to this individual provider in the NPPES registry on July 14, 2019.

Where is Molly Wickenhauser located?

Molly Wickenhauser practices at 915 N Grand Blvd, Saint Louis, MO 63106. The listed phone number is (314) 652-4100.

What is Molly Wickenhauser's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Molly Wickenhauser enrolled in Medicare?

No. Molly Wickenhauser has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Molly Wickenhauser was last updated on April 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.