Individual provider Active NPI

Atia Jonte Wise, LCMHC

  • Mental Health Counselor
  • Raleigh, NC
National Provider Identifier
1073069068
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12120 Issued in NC
Practice address
8406 Six Forks Rd Ste 104
Raleigh, NC 27615-3075
Phone
(919) 373-2868
NPI assigned
Aug 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X S12120 NC
Mental Health Counselor 101YM0800X 12120 NC Primary

Addresses

Primary practice location

8406 Six Forks Rd Ste 104
Raleigh, NC 27615-3075

Mailing address

610 Purple Aster St
Youngsville, NC 27596-4403
Phone (919) 824-7394

Other names 1

  • Dr. Atia Saunders Wise Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231201001767 NC Practitioner - Mental Health Counselor 0749638757 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S12120NCMDProfessional Counselor
12120NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - North Carolina PC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

119 SW Maynard Rd
Cary, NC 27511
Phone (919) 415-1112

8406 Six Forks Rd
Ste 104
Raleigh, NC 27615
Phone (855) 675-4144

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1073069068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 PURPLE ASTER ST",
            "city": "YOUNGSVILLE",
            "state": "NC",
            "postal_code": "275964403",
            "telephone_number": "919-824-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8406 SIX FORKS RD STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153075",
            "telephone_number": "919-373-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "ATIA",
        "middle_name": "JONTE",
        "name_prefix": "Dr.",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "S12120",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "12120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ATIA",
            "last_name": "WISE",
            "middle_name": "SAUNDERS",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.