Stephanie Wiese

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180007986 Issued in IL

Legal business name

STEPHANIE WIESE

Doing business as

Fox Bend Counseling

Practice address

123 W Washington St
Suite 340
Oswego, IL 60543-8214

Phone

(630) 818-7899

NPI assigned

Jun 27, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Stephanie Wiese, LCPC

Title

Owner

Phone

(630) 818-7899

Specialties & licenses 1

Addresses

Other names 1

• Fox Bend Counseling Doing business as

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1114281870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 SPRINGBROOK TRL S",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605434016",
            "telephone_number": "630-818-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W WASHINGTON ST",
            "address_2": "SUITE 340",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605438214",
            "telephone_number": "630-818-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIE WIESE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "WIESE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-818-7899",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180007986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fox Bend Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Oswego, IL
• Providers in Oswego, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.