Active NPI
Vonthisha C Wiley, LCSW
- Clinical Social Worker
- Monroe, LA
National Provider Identifier
1053033795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14370
- Practice address
- 422 Bunker LN
Monroe, LA 71203-8956 - Phone
- (318) 497-3264
- NPI assigned
- Sep 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 14370 | LA | Primary |
Addresses
Primary practice location
422 Bunker LN
Monroe, LA 71203-8956
Mailing address
422 Bunker LN
Monroe, LA 71203-8956
Phone (318) 497-3264
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14370 | Other | LA | LICENSE CLINICAL SOCIAL WORKER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14370 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663545600000",
"number": "1053033795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "422 BUNKER LN",
"city": "MONROE",
"state": "LA",
"postal_code": "712038956",
"telephone_number": "318-497-3264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "422 BUNKER LN",
"city": "MONROE",
"state": "LA",
"postal_code": "712038956",
"telephone_number": "318-497-3264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "VONTHISHA",
"middle_name": "C",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-19",
"last_updated": "2022-09-19",
"certification_date": "2022-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "14370",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE CLINICAL SOCIAL WORKER",
"identifier": "14370",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.