Individual provider Active NPI

Robert Allen Wiley, MA, , LMHC, LPC

  • Counselor
  • Kea'au, HI
National Provider Identifier
1063533032
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401006190 Issued in MI
Practice address
16-179 Melekahiwa St
Keaau, HI 96749-8026
Phone
(808) 854-2837
Fax
(808) 969-3716
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401006190 MI Primary

Addresses

Primary practice location

16-179 Melekahiwa St
Keaau, HI 96749-8026

Mailing address

PO Box 585
Honokaa, HI 96727-0585
Phone (989) 859-7155

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401006190MIMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1063533032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 585",
            "city": "HONOKAA",
            "state": "HI",
            "postal_code": "967270585",
            "telephone_number": "989-859-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16-179 MELEKAHIWA ST",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967498026",
            "telephone_number": "808-854-2837",
            "fax_number": "808-969-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "ROBERT",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "MA, , LMHC, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401006190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kea'au, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.