MEDICARE: DR. WAYNE CARLTON ETHERIDGE PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	04-019-PSY	VI

General Provider Information

NPI Number	:	1609923713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE CARLTON ETHERIDGE PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 26461
Second Line	:
City	:	ST CROIX
State	:	VI
Zip	:	00824-2461
Country	:	US
Telephone Number	:	340-719-7007
Fax Number	:

Provider Business Practice Location Address
First Line	:	5030 ANCHOR WAY
Second Line	:
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4692
Country	:	US
Telephone Number	:	340-773-7772
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	01/14/2020

Similar Medicare Providers

1366646770 — DR. KURT B BUSKA D.D.S.
Practice Location Address:

5030 ANCHOR WAY, SUITE 8 , GALLOWS BAY
CHRISTIANSTED, VI
00820-4692

Practice Phone: 340-719-7000
Practice Fax:

1801071816 — JULIE W SOMMER MSOT, OTR/L
Practice Location Address:

5030 ANCHOR WAY STE 9
CHRISTIANSTED, VI
00820-4692

Practice Phone: 340-277-4995
Practice Fax: 866-411-7667

1124273412 — LINDSY KAE YARGER-WAGNER PSYD
Practice Location Address:

5030 ANCHOR WAY STE 9
CHRISTIANSTED, VI
00820-4692

Practice Phone: 340-719-7007
Practice Fax: 340-719-6655

1154608016 — JS THERAPIES, LLC
Practice Location Address:

5030 ANCHOR WAY STE 9
CHRISTIANSTED, VI
00820-4692

Practice Phone: 340-277-4995
Practice Fax: 866-411-7667

1245648146 — DR. SOPHIA JOSEPH PARRILLA PHD, CLINICAL PSYCH
Practice Location Address:

5030 ANCHOR WAY STE 7
CHRISTIANSTED, VI
00820-4692

Practice Phone: 340-719-7007
Practice Fax: 340-719-6655

1548617418 — ALLISON JANUSZIEWICZ
Practice Location Address:

5030 ANCHOR WAY STE 7
CHRISTIANSTED, VI
00820-4692

Practice Phone: 340-719-7007
Practice Fax:

Directions to “ DR. WAYNE CARLTON ETHERIDGE PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.