Welton Miguel Wiley, LAC, CCS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LAC 880 Issued in LA

Practice address

602 E Georgia Ave
Ruston, LA 71270-3931

Phone

(318) 251-4125

Fax

(318) 251-5000

NPI assigned

Feb 1, 2007

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1154469559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 OSCAR RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712921298",
            "telephone_number": "318-396-4904",
            "fax_number": "318-362-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 E GEORGIA AVE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712703931",
            "telephone_number": "318-251-4125",
            "fax_number": "318-251-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "WELTON",
        "middle_name": "MIGUEL",
        "name_prefix": "Mr.",
        "credential": "LAC, CCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "LAC 880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Wheeler, MS, ATC, LAT, CSCS
• Payton Barrett Whiddon, MD
• Allen Whitaker
• Elizabeth White, PT, DPT
• Jacquelyn Kibodeaux White, M.D.
• Dennis Wilford
• Korick Wilkerson
• Lovely Wilkerson, DPT
• Catherine Williams-Fortenberry
• Andrea Williams, LPC

• Addiction (Substance Use Disorder) Counselor in Ruston, LA
• Providers in Ruston, LA by specialty
• Addiction (Substance Use Disorder) Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.