Wise Roots Wellness, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149015015 Issued in IL

Legal business name

WISE ROOTS WELLNESS, LLC

Practice address

3600 W Wrightwood Ave
Chicago, IL 60647-1138

Phone

(312) 445-8906

NPI assigned

Mar 16, 2013

Last updated

Mar 16, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Virginia Wyatt WhartonNPI 1801912795

Title

Owner

Phone

(312) 259-2112

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Virginia W Wharton, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1801912795
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363392000000",
    "number": "1023350063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 W ATTRILL ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W WRIGHTWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471138",
            "telephone_number": "312-445-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE ROOTS WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-16",
        "last_updated": "2013-03-16",
        "status": "A",
        "authorized_official_last_name": "WHARTON",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "WYATT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-259-2112"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wise Behavioral Health Services LTD
• Wise Guys Counseling
• Wise Health Professional Corporation
• Wise Health Professional Corporation
• Wise Mind Psychotherapy
• Elisabeth A Wise
• Kelly Wise
• Rachel Wise, DPT
• Robert Arthur Wise, MD
• Sharon I Wise

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.