Ebony Dechelle Wiggins

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

681 Cottage St NE
Salem, OR 97301-2419

Phone

(336) 314-7105

NPI assigned

Oct 23, 2024

Last updated

Oct 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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

• Innervision Health Services, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Salem, OR
  • NPI 1548022601

  Peer Specialist

  NPD Authorized official
• Innervision Wellness Services, Inc

  • Lodging Provider
  • Salem, OR
  • NPI 1821852989
  NPD Authorized official
• Truth Behavioral Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Mill, SC
  • NPI 1528428851

  Peer Specialist

  NPD Authorized official

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1124849971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 COTTAGE ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012419",
            "telephone_number": "336-314-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 COTTAGE ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012419",
            "telephone_number": "336-314-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "EBONY",
        "middle_name": "DECHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Wichman
• Adrienne Marie Wiens, LMFT
• Theron J Wiese, PA-C
• Jeff Allan Wiesinger, CHW
• Brittney Diane Wiggins, M.A
• Amanda Michele Wilcox, QMHA
• Amber Wilcox, CMA
• Rebekah Wilcox
• Barbara Wilcut
• Anne Marie Wild, MD

• Peer Specialist in Salem, OR
• Providers in Salem, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.