Regina Katherine Wisenbaker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW005046 Issued in GA

Practice address

2704 N Oak St BLDG J
Valdosta, GA 31602-1768

Phone

(229) 262-7333

Fax

(229) 262-7335

NPI assigned

Sep 3, 2013

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

Enrolled in GA

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

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Regina Katherine Wisenbaker

  dba Wisenbaker Counseling Services, LLC

  • Community Health Worker
  • Valdosta, GA
  • NPI 1922420579
  Medicare reassignment NPD Authorized official
• Ashley Shapiro, LLC

  • Clinical Social Worker
  • Valdosta, GA
  • NPI 1144707480
  NPD (past)
• Paris C Shields LLC

  • Clinical Social Worker
  • Valdosta, GA
  • NPI 1417300690
  NPD (past)

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1144654674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 N OAK ST BLDG J",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021768",
            "telephone_number": "229-262-7333",
            "fax_number": "229-262-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 N OAK ST BLDG J",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021768",
            "telephone_number": "229-262-7333",
            "fax_number": "229-262-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISENBAKER",
        "first_name": "REGINA",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winnersville Pharmacy LLC (Amerimed Long-Term Care Packaging)
• Winnersville Pharmacy, LLC (Amerimed Pharmacy)
• July Wise
• Marcie C Wiseman, PHD
• Chaeli Wisenbaker, PA-C
• Patricia M Wittenborn, LCSW
• Anna Wolford, PP
• Robertus Wolters, RPT
• Kathryn Marie Woltz, PA-C
• Bryan Wood, RBT

• Clinical Social Worker in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.