Individual provider Active NPI

Anna M Wheelock, LPC, CSAC

  • Professional Counselor
  • Antigo, WI
National Provider Identifier
1134489883
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4375-125 Issued in WI
Practice address
1225 Langlade Rd
Antigo, WI 54409-2762
Phone
(715) 627-6694
Fax
(715) 627-6645
NPI assigned
May 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4375-125 WI Primary

Addresses

Primary practice location

1225 Langlade Rd
Antigo, WI 54409-2762

Mailing address

1100 Lake View Dr
Wausau, WI 54403-6785
Phone (715) 848-4600

Other identifiers 2

IdentifierTypeStateIssuer
4375-125OtherWILICENSE - LPC
14380-132OtherWILICENSE - CSAC

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

LicenseStateTypeSpecialty
4375-125WIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1134489883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAKE VIEW DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036785",
            "telephone_number": "715-848-4600",
            "fax_number": "715-845-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 LANGLADE RD",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092762",
            "telephone_number": "715-627-6694",
            "fax_number": "715-627-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELOCK",
        "first_name": "ANNA",
        "middle_name": "M",
        "credential": "LPC, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4375-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE - LPC",
            "identifier": "4375-125",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE - CSAC",
            "identifier": "14380-132",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Antigo, WI

Sources for this page

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